East Bay Community Action Program

Referral Coordinator (multiple vacancies)

East Bay Community Action Program  •  Barrington, RI (Onsite)  •  8 days ago
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Job Description

Referral Coordinator (multiple vacancies)

Department: Health Operations

Employment Type: Full Time

Location: Barrington - OCR

Reporting To: Manager Health Information


East Bay Community Action Program is hiring for a full-time Referral Coordinator to manage the patient referral process, including coordination between providers, insurance verification, authorization processing, and scheduling. This position requires experience in EHR systems, strong communication skills, and the ability to navigate complex healthcare processes while providing excellent customer service to patients.

Key Responsibilities

  • Process and track all incoming and outgoing referrals using NextGen EHR system
  • Verify insurance coverage and obtain prior authorizations for services
  • Schedule patient appointments when permitted, and coordinate necessary clinical information transfer
  • Maintain accurate documentation of all referral activities within NextGen
  • Follow up on pending referrals to ensure timely completion
  • Communicate with patients regarding referral status, appointment details, and preparation instructions
  • Coordinate with specialist offices to confirm referral status, dates of scheduled appointments, and obtain consultant notes for referral completion
  • Liaise with insurance companies to resolve coverage issues and denials
  • Review referral reports to identify open referrals, ensure timely completion, and close out expired referrals as needed.
  • Ensure compliance with HIPAA regulations and organizational policies
  • Participate in quality improvement initiatives related to the referral process

Qualifications

  • High school diploma/GED required
  • 1-2 years of professional experience in a healthcare setting and with insurance authorizations
  • Basic knowledge of healthcare terminology
  • Strong communication skills, detail oriented with a strong patient service mindset
  • Knowledge of 42 Code of Federal Regulations (CFR) Part 2 and HIPAA compliance

Benefits

  • Comprehensive medical and dental insurance plans (BCBSRI) with heavy subsidization
  • Supplemental vision insurance
  • Voluntary medical and dependent care flexible spending accounts
  • Up to 3% matching 403(b) retirement plan
  • Employer-paid life insurance & long-term disability
  • Generous paid time off including vacation, holidays, personal days, and sick time
  • Mileage reimbursement
  • Tuition reimbursement
  • Center-paid training/CEUs opportunities
  • Employee assistance program

We welcome candidates from all backgrounds who are passionate about making a difference in our community.

East Bay Community Action Program

About East Bay Community Action Program

East Bay Community Action Program (EBCAP) is a private, non-profit 501 (c) (3) corporation. The mission of EBCAP is to provide high-quality, comprehensive and accessible health and human services to assist people to achieve their fullest potential.

In 2016 EBCAP merged with East Bay Center (EBC), a state recognized Community Mental Health Center (CMHC) and Integrated Health Home. Given that the two were recognized at the local, state, and national levels as premier providers, the transformation and merger into a single organization greatly enhanced the level of expertise and expanded the breadth and depth of services that EBCAP could offer to the communities it serves.

With this merger, EBCAP received provisional approval by the state as an Accountable Care Entity, an in-house partnership of medical, dental, behavioral health, and social service providers working together to create a shared culture of collaboration and transformation of the health care system. The ACE will focus on supporting high quality care, enhancing health information technology, and experiencing shared savings through agreements with major Medicaid providers, such as Neighborhood Health Plan of RI.

EBCAP is proud to provide a full array of services including integrated family health, behavioral, and dental services; Head Start and Early Head Start; Women, Infants and Children; family development; Healthy Families America home visiting; Heating and Energy Assistance; Victims of Crime Act information and referral services; and much more!

The vision of EBCAP is to be recognized as the premier human service agency in the east bay.

Industry
Nonprofit & NGOs
Company Size
201-500 employees
Headquarters
East Providence, RI
Year Founded
1965
Website
ebcap.org
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