Referral Coordinator (multiple vacancies)

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

About
East Bay Community Action Program (EBCAP) is a non-profit 501(c)(3) organization that provides high-quality, comprehensive, and accessible health and human services to people across eastern Rhode Island. Founded as part of President Johnson's War on Poverty in 1965, EBCAP now serves ten communities with over 20 distinct programs — including primary medical and dental care, behavioral health services, early childhood education, and community support programs for children, youth, families, adults, and seniors.Our 521 employees work across more than ten locations, addressing everything from immediate needs like food and housing to long-term health and wellness. If you are looking to make a meaningful impact on the lives of Rhode Islanders, we encourage you to apply.