Referral Coordinator

This position is eligible for an additional sign on bonus.

The Referral Coordinator supports the facilitys off-site medical referral and continuity-of-care process for patients in custody. The role coordinates non-emergent and emergent off-site medical referrals authorizations appointments provider communications required documentation and follow-up actions in accordance with contract requirements approved referral processes and facility medical policies. 

The Referral Coordinator serves as the facility point of contact for community medical referrals and related communications maintains current provider and hospital contact information supports timely entry and adjudication of referral records coordinates custody transport for authorized appointments and helps ensure that transfer discharge release and removal packets include required medical documentation medications and continuity-of-care information. 

The Referral Coordinator maintains accurate records within approved systems supports confidentiality and records handling requirements and works with on-site clinical and operational teams to promote timely access to medically necessary off-site care. 

Key Responsibilities:

• Serve as the primary facility point of contact for community medical referrals and related communications with community providers billing partners designated government medical authority staff and internal stakeholders. 
• Manage administrative aspects of off-site medical referrals including making appointments sending authorizations tracking status documenting outcomes and completing timely referral adjudication. 
• Ensure all patients receiving off-site medical services have a corresponding Medical Payment Authorization Request referral entered and maintained in the required system in accordance with contract requirements. 
• Enter emergency department and hospital admission referral records within one business day after the patient is discharged from the hospital. 
• Coordinate with clinical staff to support timely pre-approval for non-emergent care and post-approval actions for emergent care. 
• Arrange custody transport for authorized community provider appointments and coordinate operational logistics with facility and transportation personnel. 
• Provide and maintain a current comprehensive list of hospitals and community providers including specialty type transport address contact information billing identifiers and related referral data. 
• Respond to referral authorization billing and claims communications by mail email or telephone and collaborate with the designated government medical authority as applicable for timely resolution. 
• Assist community providers with denied-claim issues by gathering required case and billing information and escalating for review within required timelines. 
• Support continuity of care during patient transfer by coordinating required documentation and confirming that the Medical Transfer Summary or equivalent includes current medications diagnoses appointments consultations and equipment needs. 
• Coordinate with clinical staff to help ensure patients scheduled for transfer release or removal receive the required medication supply and supporting medical paperwork in accordance with contract and facility procedures. 
• Maintain accurate electronic referral and communication records and provide reports or records when requested by authorized stakeholders. 
• Protect patient confidentiality and handle records in accordance with applicable privacy security and records-management requirements. 
• Support access to off-site emergency medical providers by maintaining current emergency contact information for medical dental and mental health services available twenty-four hours per day seven days per week. 
• Participate in quality improvement risk management and process reviews related to referrals appointments transfers and continuity of care. 
• Escalate urgent clinical operational or documentation issues immediately to the appropriate medical or operational leadership. 
• Complete required initial annual and role-related training assigned by the employer client or applicable regulatory and accreditation bodies. 
• Perform other contract-aligned duties within the scope of referral coordination records support appointment management and continuity-of-care administration. 
• Completes required organizational compliance education including assigned requirements that are client-specified for Joint Commission Healthcare Staffing Services certification or other regulatory bodies.   

This list is non-exhaustive and the role holder may be required to undertake additional duties that are not specifically listed above. 

Qualifications :

Experience Required: 

• Experience coordinating off-site medical referrals specialty appointments hospital communications medical records support or continuity-of-care processes in a healthcare setting. 
• Experience maintaining accurate records in an Electronic Health Record system and other required referral or case-tracking systems. 
• Experience communicating with clinical teams outside providers and operational stakeholders regarding appointments authorizations and patient movement. 
• Experience handling confidential health information in accordance with applicable privacy and security requirements. 
• Ability to manage multiple referrals appointments deadlines and follow-up actions in a high-volume time-sensitive environment. 
• Ability to prepare track and reconcile referral and transfer documentation with accuracy and attention to detail. 

Education Required: 

• Must have and maintain an unrestricted and current license as an LVN/LPN/RN issued by the state of Maryland or the ability to obtain one.   
• Current Basic Life Support (BLS) Certification. 
• Advanced Cardiac Life Support (ACLS) is preferred. 
• Proficiency in both English and Spanish is preferred. 
• Case Management Certification by ANCC preferred. 

Knowledge and Skills Required 

• Working knowledge of medical referral workflows hospital and specialty appointment coordination transfer documentation and continuity-of-care requirements. 
• Working knowledge of Electronic Health Record documentation and referral tracking. 
• Ability to maintain comprehensive provider contact lists and manage referral-related communications. 
• Ability to coordinate effectively with on-site medical teams transportation personnel and community providers. 
• Strong written and verbal communication skills. 
• Strong organizational skills time management and follow-through. 
• Ability to protect confidential information and follow privacy security and records-retention procedures. 

Physical Requirements: 

• Required to walk unaided at a normal pace for up to 5 minutes and maintain balance. 
• Required to jog/fast walk up to ¼ mile. 
• Requires physical exertion such as lifting objects greater than 30 pounds. 
• Required to perform CPR/emergency care standing or kneeling. 
• Must have the ability to assist sick injured or aging patients or staff exiting the building (may require lifting dragging wheeling or carrying someone who weighs significantly more than self). 
• Must be able to see hear and smell with aids if necessary. 
• Must be able to lift push or carry 30 pounds. 
• Must perform the duties of my job in a stressful and often austere environment without physical limitations. 
• Sitting and/or standing for extended periods of time. 
• Average manual dexterity for computer operation. 
• Phone or computer use for extended periods of time. 

Other Special Qualifications: 

• Must maintain current/physical residency in the continental U.S. 
• Pass a medical examination conducted by a licensed physician within 30 days prior to initial assignment. 
• U.S. citizen and have resided in the U.S. for the last five years (unless abroad on official U.S. government duty). 
• Successfully engage in and complete a thorough Background Investigation. 
• Poses or have ability to obtain required security clearances. 
• Proficiency in Spanish is preferred. 

Additional Information :

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Compensation Disclaimer:
Pay range is based on several factors and may vary in addition to a full range of medical financial and/or other benefits. Final salary and offer will be determined by the applicants background experience skills internal equity and alignment with geographical market data.

Benefits Language (FTE roles):
Full-time positions are eligible for our comprehensive and competitive benefits package including medical dental vision and basic life insurance. Additional benefits include a 401k plan paid time off and an annual bonus. IHMS USA Inc. complies with all federal state and local minimum wage laws.

Equal Opportunity Employer (EEO) Statement:
IHMS USA Inc. is an equal opportunity employer and does not discriminate against employees or job applicants on the basis of race color religion gender sexual orientation gender identity national origin age disability genetic information marital status amnesty or status as a covered veteran in accordance with applicable federal state and local laws.

Remote Work :

No

Employment Type :

Full-time