Referral Coordinator

Responsibilities

• Serve as the primary facility point of contact for community medical referrals and related communications with community providers, billing partners, designated government medical authority staff, and internal stakeholders.
• Manage administrative aspects of off-site medical referrals, including making appointments, sending authorizations, tracking status, documenting outcomes, and completing timely referral adjudication.
• Ensure all patients receiving off-site medical services have a corresponding Medical Payment Authorization Request referral entered and maintained in the required system in accordance with contract requirements.
• Enter emergency department and hospital admission referral records within one business day after the patient is discharged from the hospital.
• Coordinate with clinical staff to support timely pre-approval for non-emergent care and post-approval actions for emergent care.
• Arrange custody transport for authorized community provider appointments and coordinate operational logistics with facility and transportation personnel.
• Provide and maintain a current, comprehensive list of hospitals and community providers, including specialty type, transport address, contact information, billing identifiers, and related referral data.
• Respond to referral, authorization, billing, and claims communications by mail, email, or telephone and collaborate with the designated government medical authority as applicable for timely resolution.
• Assist community providers with denied-claim issues by gathering required case and billing information and escalating for review within required timelines.
• Support continuity of care during patient transfer by coordinating required documentation and confirming that the Medical Transfer Summary or equivalent includes current medications, diagnoses, appointments, consultations, and equipment needs.
• Coordinate with clinical staff to help ensure patients scheduled for transfer, release, or removal receive the required medication supply and supporting medical paperwork in accordance with contract and facility procedures.
• Maintain accurate electronic referral and communication records and provide reports or records when requested by authorized stakeholders.
• Protect patient confidentiality and handle records in accordance with applicable privacy, security, and records-management requirements.
• Support access to off-site emergency medical providers by maintaining current emergency contact information for medical, dental, and mental health services available twenty-four hours per day, seven days per week.
• Participate in quality improvement, risk management, and process reviews related to referrals, appointments, transfers, and continuity of care.
• Escalate urgent clinical, operational, or documentation issues immediately to the appropriate medical or operational leadership.
• Complete required initial, annual, and role-related training assigned by the employer, client, or applicable regulatory and accreditation bodies.
• Perform other contract-aligned duties within the scope of referral coordination, records support, appointment management, and continuity-of-care administration.
• Completes required organizational compliance education, including assigned requirements that are client-specified, for Joint Commission Healthcare Staffing Services certification or other regulatory bodies.
• This list is non-exhaustive, and the role holder may be required to undertake additional duties that are not specifically listed above.
• Experience Required:
• Experience coordinating off-site medical referrals, specialty appointments, hospital communications, medical records support, or continuity-of-care processes in a healthcare setting.
• Experience maintaining accurate records in an Electronic Health Record system and other require

Benefits

Additional Information

This position is contingent on contract award. The Referral Coordinator supports the facility's off-site medical referral and continuity-of-care process for patients in custody. The role coordinates non-emergent and emergent off-site medical referrals, authorizations, appointments, provider communications, required documentation, and follow-up actions in accordance with contract requirements, approved referral processes, and facility medical policies. The Referral Coordinator serves as the facility point of contact for community medical referrals and related communications, maintains current provider and hospital contact information, supports timely entry and adjudication of referral records, coordinates custody transport for authorized appointments, and helps ensure that transfer, discharge, release, and removal packets include required medical documentation, medications, and continuity-of-care information. The Referral Coordinator maintains accurate records within approved systems, supports confidentiality and records handling requirements, and works with on-site clinical and operational teams to promote timely access to medically necessary off-site care.

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