Please note: This position is based at our off-site clinic located at 2315 8th Street – Lewiston, ID and is not at the main hospital campus.

At ScionHealth, we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking. Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates.

Job Summary

• The Referral Coordinator ensures that all referral and prior authorization processes are completed accurately and efficiently to support patient access, clinical care coordination, and financial sustainability. This position serves as a liaison between patients, providers, payers, and internal departments to facilitate timely service delivery while maintaining regulatory compliance and excellent customer service.

Essential Functions

• Submits and monitors prior authorizations and referral requests through payer portals, fax, or phone
• Ensures complete and accurate documentation, including provider/payer details, CPT/HCPC/ICD-10 codes, visit counts, and authorization numbers
• Verifies patient insurance eligibility and benefits using payer systems and EMR tools
• Communicates with providers, schedulers, and patients regarding authorization status and medical necessity concerns
• Documents all referral and authorization activity in the electronic medical record per departmental protocols
• Assists in appeals or follow-up on denied authorizations and incomplete submissions
• Maintains knowledge of payer-specific guidelines, policies, and submission processes
• Provides courteous and compassionate service to patients and their families; engages calmly and confidently to reduce anxiety
• Supports scheduling, coverage, and workflow optimization across fluctuating patient volumes
• Ensures use of appropriate PPE and compliance with hospital safety and emergency procedures

Knowledge/Skills/Abilities/Expectations

• Familiarity with ICD-10, CPT, and HCPC coding standards
• Basic proficiency in Microsoft Outlook, Word, Excel, and electronic health record systems
• Strong customer service and communication skills across phone, email, and in-person interactions
• Ability to document clearly and accurately using correct terminology and approved acronyms
• Ability to manage time effectively, multitask, and respond to urgent requests
• Understanding of HIPAA and confidentiality practices
• Frequent sitting, computer use, and telephone communication
• Ability to remain stationary for extended periods (up to 80%)
• Occasional movement between on-site and off-site locations as needed
• Primarily indoor office environment with frequent interaction with the public
• Minimal exposure to biohazards and office-related chemicals
• Occasional travel between hospital and off-campus sites; appropriate attire required

Education

• High school diploma or equivalent required

Licenses/Certifications

• None required
• Medical coding or billing certification preferred

Experience

• Minimum of 1 year in a healthcare environment performing relevant duties required
• Experience in referral coordination, medical office operations, or health insurance authorization preferred