Description

Overview

The Referral Coordinator plays an essential role in the care coordination team by managing all aspects of the referral process to ensure patients receive timely access to specialty services, diagnostic testing, procedures, and medications. This position serves as the communication bridge between providers, internal staff, external specialists, and patients, ensuring referral requirements are completed accurately and efficiently.

The role requires strong organizational skills, attention to detail, and excellent communication to maintain accurate documentation in the electronic medical record (EMR) and support a smooth patient experience.

Responsibilities
Referral Management
Initiate, process, and track incoming and outgoing referrals.
Review provider orders and ensure required documentation (notes, imaging, labs) is submitted to specialists or facilities.
Scheduling & Follow-Up
Schedule, cancel, or reschedule referral-related appointments according to guidelines.
Monitor referrals through completion, including follow-up and obtaining specialist reports.
Insurance Verification & Prior Authorizations
Verify patient insurance eligibility and coverage for referred services.
Obtain prior authorizations for visits, procedures, diagnostics, or medications.
Coordinate communication with insurance payors.
Electronic Medical Record (EMR) Management
Accurately document all referral activity in the EMR.
Scan and upload referral-related records.
Keep patient charts updated and organized.
Patient Communication
Inform patients of referral status, appointment details, and required steps.
Provide guidance on specialist locations, insurance expectations, and next steps.
Message Handling
Answer calls and in-person inquiries professionally.
Take and route clear, accurate messages according to clinic protocols.
Chart Preparation & Support (Clinic Dependent)
Ensure records and referral documentation are available in the chart before appointments.
Verify insurance and forms as needed.
No-Show Documentation
Document no-shows in the EMR when necessary and follow clinic procedures for follow-up.
Team Collaboration
Work closely with providers, nursing staff, the front office, and the business office.
Provide coverage or assistance to front office operations when needed.
Customer Service & Confidentiality
Maintain a patient-centered approach with excellent customer service.
Uphold confidentiality standards and follow HIPAA guidelines.
Work Schedule Flexibility
Adapt to varying shifts or extended hours based on clinic needs.
Adjust responsibilities as workload or patient volume changes.
Other Duties
Perform additional tasks or projects assigned by clinic leadership.

Requirements

Qualifications
Education
Required:

High school diploma or equivalent.
Preferred:

None.