Shared Market Clinical - Referral Coordinator

Archwell-Health-; Tucson (AZ); On-site; USD 42,000 - 60,000; Full time

Job summary

ArchWell Health is seeking a Referral Coordinator to guide seniors through the healthcare system, ensuring they meet with the right specialists and receive timely care inside or outside the center.

The ideal candidate will understand Medicare criteria, coordinate with care teams, document referrals accurately, and support families while maintaining HIPAA confidentiality.

Qualifications

• Hands-on experience coordinating referrals across care teams.
• Ability to interpret and relay medical information clearly.
• Familiarity with insurance authorization and benefits workflows.
• Proven ability to maintain HIPAA compliance in a fast-paced setting.

Responsibilities

• Partner with ArchWell Health's multi-disciplinary care team to gain a deep understanding of each member's care needs, including identifying gaps and barriers to treatment
• Coordinate referrals to external providers, vendors, and services to ensure care needs are met
• Complete proper documentation for member referrals to ensure records are accurate and current
• Build and nurture relationships with members and their families to successfully facilitate care coordination
• Carry out all activities and provide ongoing monitoring as outlined in a member's care plan to ensure routine follow up and progression is made on care plan goals
• Adhere to HIPAA standards and confidentiality of protected health information (PHI)
• Promote clear communication among care team and treating clinicians to ensure positive member outcomes
• Assist members in problem solving potential issues related to the health care system, financial or social barriers (e.g., request interpreters as appropriate, transportation services or prescription assistance).
• Be the system navigator and point of contact for members and families, with patients and families having direct access for asking questions and raising concerns.
• Additional duties, as assigned

Skills

Healthcare ecosystem

Senior care advocacy

Diversity awareness

Medical terminology

Medicare knowledge

CPT ICD-10 codes

Community resources

Communication skills

Multi-tasking

Microsoft Office

Spanish fluency

Education

High School Diploma

Healthcare coursework preferred

Tools

eClinicalWorks

EMR systems

Job description

ArchWell Health is a new, innovative healthcare provider devoted to improving the lives of our senior members. We deliver best-in-class care at comfortable, accessible neighborhood clinics where seniors can feel at home and become part of a vibrant, wellness-focused community. Our members experience greater continuity of care, as well as the comfort of knowing they will be treated with respect by people who genuinely care about them, their families, and their communities.

Job Summary:

The Referral Coordinator is responsible for supporting our members as they navigate the complex healthcare delivery system, ensuring every member receives the right care in the right setting. This individual will serve as a guide for the member and their families to ensure the member meets with the right specialists, inside or outside the center, in a timely manner. An ideal candidate will have a deep understanding of the healthcare ecosystem, have strong attention to detail, and be driven by a passion for providing quality care to seniors.

Duties/Responsibilities:

• Partner with ArchWell Health's multi-disciplinary care team to gain a deep understanding of each member's care needs, including identifying gaps and barriers to treatment
• Coordinate referrals to external providers, vendors, and services to ensure care needs are met
• Complete proper documentation for member referrals to ensure records are accurate and current
• Build and nurture relationships with members and their families to successfully facilitate care coordination
• Carry out all activities and provide ongoing monitoring as outlined in a member's care plan to ensure routine follow up and progression is made on care plan goals
• Adhere to HIPAA standards and confidentiality of protected health information (PHI)
• Promote clear communication among care team and treating clinicians to ensure positive member outcomes
• Assist members in problem solving potential issues related to the health care system, financial or social barriers (e.g., request interpreters as appropriate, transportation services or prescription assistance).
• Be the system navigator and point of contact for members and families, with patients and families having direct access for asking questions and raising concerns.
• Additional duties, as assigned

Required Skills/Abilities:

• Deep understanding of the healthcare ecosystem, ideally with experience in benefits and insurance authorization
• Passion for helping senior members successfully carry out care plans
• Ability to work effectively with diverse populations including staff, providers, members, family members, insurance carriers, vendors, and the public
• Basic medical terminology
• Understanding of Medicare criteria for equipment and supplies
• Knowledge of CPT and ICD-10 codes
• Working knowledge of specialists and community resources to assist the member
• Strong communication and rapport-building ability among an interdisciplinary team
• Ability to multi-task and manage competing priorities with high attention to detail
• Proficient PC skills to include Microsoft Office
• Fluency in Spanish, or languages spoken by the people in the communities we serve (where necessary)

Education and Experience:

• H.S. Diploma or equivalent required; degree or college level coursework in healthcare preferred
• 2 years of experience in referral management or care coordination
• Medical Assistant or medical administrative experience is helpful
• Experience with EMR systems, ideally eClinicalWorks or similar

ArchWell Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to their race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected classification.