Referral Coordinator in South Boston, Massachusetts at SOUTH BOSTON COMMUNITY HEALTH

About South Boston Community Health Center

South Boston Community Health Center (SBCHC) is a mission driven, community based health organization committed to providing accessible, high quality, and compassionate care to all patients, regardless of status or ability to pay. We proudly serve a diverse community and strive to advance health equity through primary and preventive care. Our work is rooted in respect, commitment, diversity, competence, education, research, and cost effectiveness.

Work Environment & Culture

SBCHC offers a fast paced, collaborative healthcare environment where teamwork, accountability, and respect are highly valued. Employees work closely with interdisciplinary teams to support patient centered operations and a safe, well maintained care environment. We are committed to fostering an inclusive workplace and maintaining facilities that support exceptional care for patients, staff, and visitors.

Position Summary

The Referral Coordinator is responsible for coordinating patient referrals for South Boston Community Health Center to ensure timely, accurate, and seamless access to internal and external specialty care. This role serves as a key liaison between patients, providers, specialists, and insurance companies. The Referral Coordinator supports high-quality patient care by managing referral documentation, authorizations, scheduling, and communication throughout the referral process.

Essential Duties & Responsibilities

• Receive and process referral requests for SBCHC providers and outside specialists or diagnostic services
• Determine whether managed care authorization is required for referrals
• Obtain referral authorizations or denials and communicate authorization details to patients and outside specialists
• Serve as the liaison between referring providers and external specialists
• Schedule internal and external specialty and diagnostic appointments
• Notify patients of scheduled appointments and provide education regarding appointment details and preparation
• Interact with insurance companies to obtain prior authorizations, including for high-tech radiology procedures
• Process out-of-network referrals and workers’ compensation cases
• Document all referral-related information, actions taken, and communications in the electronic medical record
• Maintain accurate and timely records in accordance with SBCHC policies and procedures
• Comply with all organizational, state, and federal regulations
• Participate in trainings, staff meetings, and quality improvement initiatives as required
• Perform other duties as assigned

• High School Diploma or equivalent required
• Knowledge of referral coordination and prior authorization processes
• Ability to manage multiple tasks and priorities in a fast-paced healthcare environment
• Strong verbal and written communication skills
• Basic computer proficiency and comfort working with electronic medical record systems

Preferred Qualifications

• Experience working in a community health center or medical office setting
• Familiarity with managed care plans and insurance authorization processes
• Experience working with diverse patient populations
• Bilingual skills a plus

Knowledge, Skills & Abilities

• Strong organizational skills and attention to detail
• Ability to maintain confidentiality and handle sensitive patient information
• Customer service–focused mindset with a commitment to patient advocacy
• Ability to work independently and collaboratively as part of a team
• Flexibility and adaptability in a fast-paced environment

Physical Requirements

• Minimal physical requirements
• Ability to perform essential job functions with or without reasonable accommodation

Benefits & Perks

SBCHC offers a comprehensive benefits package designed to support employee well being and work life balance, which may include:

• Medical, dental, and vision insurance
• Paid time off, holidays, and sick time
• Retirement plan options
• Professional development and training opportunities
• Employee assistance programs
• Other benefits in accordance with employment status and union agreements

Compliance & Employment Requirements

• Employment is contingent upon successful completion of a background check and reference checks
• Proof of COVID-19 and other required vaccinations may be required in accordance with SBCHC policy and applicable laws
• Selected candidates must meet all licensing, certification, or credentialing requirements applicable to the role

Equal Opportunity Statement

South Boston Community Health Center is an Equal Opportunity Employer and is committed to fostering a diverse, inclusive, and equitable workplace. We do not discriminate on the basis of race, color, religion, creed, national origin, ancestry, ethnicity, sex, pregnancy, age, disability, genetic information, sexual orientation, gender identity or expression, marital status, veteran or military status, or any other characteristic protected by federal, state, or local law.

SBCHC is dedicated to ensuring equal employment opportunities and creating an environment where all employees feel valued, respected, and supported. We encourage individuals from diverse backgrounds to apply and are committed to providing reasonable accommodations to qualified individuals with disabilities throughout the hiring process and during employment.