Referral & Scheduling Coordinator - Patient Access

Boston Medical Center; Boston (MA); On-site; USD 27,000 - 38,000; Full time

Job summary

Boston Medical Center is seeking a Referral Coordinator to serve as the primary liaison among patients, referring practices, and insurers to facilitate access to care. The role coordinates pre-admission, registration, and scheduling for inpatient and ambulatory services, ensuring financial clearance and smooth workflow across departments.

The position entails verifying insurance, obtaining authorizations, and guiding patients through coverage options.

Responsibilities

• Conducts interviews with patients, families, and referring providers to collect accurate demographic and financial data.
• Verifies third-party insurance coverage, including workers’ compensation and motor vehicle accident claims, to ensure proper reimbursement.
• Obtains necessary prior approvals and authorizations from managed care organizations before services are rendered.
• Documents authorization details in the hospital registration system and communicates coverage alternatives or denials to patients and clinical staff.
• Coordinates scheduling of surgical cases and follow-up appointments by analyzing OR availability, anesthesia requirements, and specialty instrument needs.
• Manages last-minute changes, such as emergencies or cancellations, to maintain optimal patient flow.
• Verifies medical necessity for procedures using designated software and performs day-of-service eligibility checks.
• Assigns medical record numbers and updates the Master Patient Index (MPI) to maintain data integrity.
• Serves as subject-matter expert for clinical and administrative staff regarding managed care guidelines.
• Attends payer orientations to operationalize new procedures and trains practice staff on updated referral protocols.
• Initiates work/repair orders and uses computer software/terminal for data entry.
• Logs issues with ITS rounder or help desk.
• Arranges delivery of expired/broken equipment/materials to repair sites.
• Tracks and returns borrowed/rented equipment.
• Generates and reviews automated reports on billing edits, registration quality, and patient no-shows.
• Identifies inefficiencies in the referral process and collaborates with the Practice Manager to implement corrective actions.
• Facilitates urgent surgical appointments and cross-books ancillary services, such as social work, interpreters, and radiology.
• Directs patients to financial counseling for assistance with free care applications.

Job description

Boston Medical Center is seeking a Referral Coordinator to serve as the primary liaison among patients, referring practices, and insurers to facilitate access to care. The role coordinates pre-admission, registration, and scheduling for inpatient and ambulatory services, ensuring financial clearance and smooth workflow across departments.

The position entails verifying insurance, obtaining authorizations, and guiding patients through coverage options.