Outside Referral Coordinator

We are seeking a detail-oriented, patient-focused Outside Referral Coordinator to join our dedicated healthcare team. In this role, you will serve as a vital link between healthcare providers, members, and clinical teams. You will handle inbound calls, gather clinical and administrative details, and process prior authorization requests with accuracy and empathy. Working in a high-volume call management setting, you will navigate policy guidelines, verify coverage criteria, and provide real-time updates while maintaining exceptional service standards. The ideal candidate brings strong reading comprehension, sharp attention to detail, and a dependable, patient-first mindset.

Prior Authorization Intake: Conduct prior authorization intake by phone with providers and members, accurately entering data into EPIC Tapestry UM.Status Updates & Customer Service: Provide prompt, professional status updates on authorization requests while delivering exceptional customer service. Benefits & Coverage Review: Review benefits, coverage criteria, and documentation guidelines across a variety of medical request types. Call Workflow Management: Efficiently manage high-volume call workflows, spending 6+ hours of an 8-hour shift handling live inquiries. Qualifications & Skills