Referral Coordinator - Pain Center (Full-Time, Days)

NorthBay Health; Fairfield (CA); On-site; USD 42,000 - 62,000; Full time

Job summary

NorthBay Health is seeking a Referral Coordinator to manage referral processes for patients and physicians, securing accurate demographics, authorizations, and payer information to prevent delays.

You will verify eligibility, document benefits in the EHR, schedule appointments, coordinate records transfer, and liaise with physicians and staff to accelerate access to care, following department protocols.

Qualifications

• Experience in medical front office with health insurance/benefits knowledge.
• 1+ year experience with referrals/consult processes in specialty care (e.g., Pulmonology, Surgery, Urology, Women’s Health, Gastroenterology, Cardiology, Infectious Disease, Endocrinology).
• Strong organizational and written/spoken communication skills essential.
• Knowledge of Windows and Microsoft Word; typing and data entry accuracy.

Responsibilities

• Gathers, updates and verifies insurance/payer information and ensures accurate entry into the practice management system.
• Verifies insurance type and eligibility for care.
• Prioritizes referrals based on clinical need and MSR.
• Completes and documents referral/scheduling for initial consult visits.
• Observes provider schedules to ensure correct appointment type and time allocation.
• Schedules referrals for other specialty services and shares necessary information with the specialty provider.
• Obtains additional information from referring provider as requested.
• Assists in collection and reporting of statistical data.
• Maintains communication with physicians, co-workers and patients.

Skills

Organizational skills

Written and spoken communication

Multi-tasking

Microsoft Word

Windows knowledge

ICD coding

Medical terminology

Insurance rules

Typing / data entry

Office equipment

Education

High school diploma or GED

Tools

None

Job description

Job Description

At NorthBay Health, the Referral Coordinator coordinates the referral process for patients and physicians utilizing access to care standards for all consults. Responsible to secure accurate patient demographics, authorizations and payer information in a timely manner to ensure patient care is not delayed. Verifies and documents eligibility and benefits for patient’s specific payers. Ensures appropriate documentation is in the patient’s Electronic Health Record (EHR). Schedules patient appointments and procedures as appropriate, and coordinates transfer of necessary records. Functions as the liaison to physicians and office staff, to expedite department/specialty access to care. Reviews and appropriately schedules patient appointments utilizing Department Specific appointment protocols.

Job Description

At NorthBay Health, the Referral Coordinator coordinates the referral process for patients and physicians utilizing access to care standards for all consults. Responsible to secure accurate patient demographics, authorizations and payer information in a timely manner to ensure patient care is not delayed. Verifies and documents eligibility and benefits for patient’s specific payers. Ensures appropriate documentation is in the patient’s Electronic Health Record (EHR). Schedules patient appointments and procedures as appropriate, and coordinates transfer of necessary records. Functions as the liaison to physicians and office staff, to expedite department/specialty access to care. Reviews and appropriately schedules patient appointments utilizing Department Specific appointment protocols.

Primary Job Duties

• Gathers, updates and verifies insurance/payer information and ensures accurate entry into the practice management system.
• Verifies insurance type and eligibility for care.
• Prioritizes referrals based on clinical need as indicated by the ordering provider, and the Medical Services Request Form (MSR).
• Completes, and documents, referral / scheduling process for all referrals for initial consult visits, as requested by the ordering provider (includes patient contacts, closure of referral, correspondence notification to PCP, as appropriate).
• Observes provider schedules to ensure appointments are booked for correct appointment type and correct time allocation.
• Schedules appointments for other specialty referrals and/or other services/procedures. Delivers appropriate information (office visits, labs, radiology reports, etc.) via fax, or in person to the specialty provider.
• Schedules appointments and procedures for referrals for numerous Multi-faceted Specialty Care Offices as required.
• Obtains additional information from referring provider when requested by consulting provider.
• Assists in collection and reporting of statistical data, as requested.
• Determines priorities for completion of support functions, tasks and projects.
• Provides applicable basic education to patients to optimize the opportunity for customer satisfaction.
• Provides assistance to Patient Services Representatives (PSR) and Medical Assistants as needed with referral duties.
• Backs up PSR positions as needed.
• Consistently demonstrates and promotes a sense of team within the immediate and extended work groups.
• Establishes and maintains effective communication with physicians, co-workers and patients.
• Participates in peer-based evaluations of other staff in specified areas as needed.
• Participates in educational programs, staff meetings and in-service meetings.
• Performs other job-related duties and responsibilities, as assigned.
• Maintains current competency files per Standards and annual requirements.

Qualifications

• Education: High school graduate or GED preferred.
• Experience: Minimum of one year’s experience in a medical front office setting with experience and knowledge of health insurance/ benefit requirements required. One or more year’s of experience working with medical insurance plans preferred. One or more years of experience working with referrals/consult processes in the specialty care setting. Examples: Pulmonology, Surgery, Urology, Women’s Health, Gastroenterology, Cardiology, Infectious Disease and Endocrinology preferred.
• Skills: Strong organizational and written/spoken communication skills essential. Ability to work independently on a variety of complex tasks, managing competing deadlines. In depth working knowledge of Windows and Microsoft Word. Knowledge of ICD-9, ICD-10 and CPT-4 coding Knowledge of medical terminology, and insurance rules and regulations required. Detail oriented with typing and computer input ability and a working knowledge of general office machines required. Strong ability to multi-task; schedule appointments for several multi-disciplinary clinics.
• Interpersonal Skills : Demonstrates the NorthBay Way. The NorthBay Way is a set of value-based behaviors that are to be consistently demonstrated and role modeled by all employees that work at NorthBay Healthcare. The NorthBay Way principles consist of Caring, Communication, Collaboration, and Competence.
• Standards of Performance: Demonstrate performance by adhering to established policies and procedures and exhibiting the defined characteristics associated with attendance and punctuality.
• Physical Effort: Attendance is an essential function of the job. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.Requires some walking; prolong hours of sitting and standing. Requires use of telephone, writing and computer keyboard six or more hours each day.Requires stooping, bending, reaching, twisting and squatting.
• Hours of Work: 40 hours per week, pre scheduled between Monday-Friday during established office hours 07:00am-05:30pm and business needs.

About Us

Interpersonal Skills and Values

Demonstrates NorthBay Health’s True North Values: Nurture Care, Own It, Respect Relationships, Build Trust, and Hardwire Excellence. These values guide behavior, accountability, teamwork, and commitment to high-quality patient care.

Why NorthBay Health

NorthBay Health is an independent, nonprofit health system serving the Napa, Solano, and Yolo County regions. We are expanding access to care across our communities through two acute-care hospitals, including a Level II Trauma Center and a Level III NICU maternity unit, along with a cancer center, urgent care locations, and a growing network of primary and specialty care clinics.

We provide advanced services in cardiovascular care, neuroscience, orthopedics, surgery, and outpatient specialties. NorthBay Health is nationally recognized for quality care, including Magnet with Distinction designation for nursing and multiple U.S. News and World Report high performing recognitions.

We are committed to being the trusted healthcare partner of choice and offer an environment where employees can grow, contribute meaningfully, and support the health of our communities.

NorthBay Health Benefits Options

NorthBay Health offers a comprehensive benefits package based on established eligibility requirements. Benefits may include medical, dental, and vision insurance, life, disability, and long-term care coverage, paid time off including vacation, sick leave, holidays, and bereavement, a 403(b) retirement plan with employer match, education reimbursement for eligible roles, professional development and training programs, Employee Assistance Program, wellness programs, recognition programs, shift differentials, and market-based compensation review and increases subject to approval and organizational performance.

Compensation Structure

NorthBay Health uses a structured compensation framework. Staff-level positions use a step-based system (Steps 1-5) based on years of directly related experience, with Step 5 representing 20 or more years of experience in the role. Manager level and above positions are paid a fixed annual base salary and are eligible for a variable incentive compensation plan. Physician compensation is structured based on specialty and role requirements.

Remote Work Disclosure

NorthBay Health is primarily an onsite organization due to the nature of healthcare. Some roles may allow hybrid or remote work based on business needs.

Remote work is not supported in Washington, Ohio, Wyoming, North Dakota, Puerto Rico, the U.S. Virgin Islands, or outside of the United States.

Notice to Recruitment Agencies

NorthBay Health utilizes a managed service provider (MSP) for agency partnerships and is not currently engaging external recruiting firms outside of established agreements. We do not accept unsolicited resumes or third-party candidate submissions. Please do not contact NorthBay Health employees, leaders, physicians, or hiring managers regarding recruitment or job postings.

More Information

Visit NorthBay Health Careers for recruitment FAQs and additional information.