Outside Services Coordinator
Company Overview #LI-Remote Shriners Children’s is an organization that respects, supports, and values each other. Named as the 2025 best mid-sized employer by Forbes, we are engaged in providing excellence in patient care, embracing multi-disciplinary education, and research with global impact. We foster a learning environment that values evidenced based practice, experience, innovation, and critical thinking. Our compassion, integrity, accountability, and resilience define us as leaders in pediatric specialty care for our children and their families. All employees are eligible for medical coverage on their first day! In addition, upon hire all employees are eligible for a 403(b) and Roth 403 (b) Retirement Saving Plan with matching contributions of up to 6% after one year of service. Employees in a FT or PT status (40+ hours per pay period) will also be eligible for paid time off, life insurance, short term and long-term disability and the Flexible Spending Account (FSA) plans and a Health Savings Account (HSA) if a High Deductible Health Plan (HDHP) is elected. Additional benefits available to FT and PT employees include tuition reimbursement, home & auto, hospitalization, critical illness, pet insurance and much more! Coverage is available to employees and their qualified dependents in accordance with the plans. Benefits may vary based on state law. Job Overview The Outside Services Coordinator is responsible for coordinating and facilitating patient services that are performed outside the four walls of the primary care site. This role ensures that medically necessary external services—such as advanced diagnostic imaging, specialty testing, or ancillary services—are authorized, scheduled as appropriate, and aligned with the patient’s overall plan of care. The Outside Services Coordinator serves as a key liaison among patients, providers, payers, and external service vendors to support timely access to care. This includes obtaining prior authorizations, communicating medical necessity requirements, assisting with appointment scheduling when necessary, and coordinating external service dates with facility-based visits to promote continuity, efficiency, and a positive patient experience.
Responsibilities
Obtain and manage prior authorizations and approvals from payers for advanced imaging and other services performed by outside providers, ensuring compliance with payer and regulatory requirements. Coordinate referrals and service requests with external vendors (e.g., imaging centers, specialty clinics, diagnostic facilities). Assist patients with scheduling outside services when applicable, including providing instructions, preparation requirements, and location details. Align external service appointments with scheduled hospital visits or procedures to minimize delays, duplicate testing, and patient burden. Communicate authorization status, scheduling details, and test requirements to patients, providers, and care teams. Track authorization timelines, denials, and expirations; initiate follow-up actions and appeals as needed. Maintain accurate documentation in the electronic health record and related tracking systems. Identify and address barriers to care, including scheduling challenges, insurance coverage issues, or vendor availability. Collaborate with internal departments (clinical teams, case management, revenue cycle, scheduling) to support seamless care transitions. This is not an all-inclusive list of this job’s responsibilities. The incumbent may be required to perform other related duties and participate in special projects as assigned.
Qualifications
Required: 3 or more years of experience working as an authorization representative in an acute care hospital, physician practice or other healthcare setting Epic EMR experience High School Diploma / GED Preferred: Pediatric experience