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.
Initiate process and track incoming and outgoing referrals.
Review provider orders and ensure required documentation (notes imaging labs) is submitted to specialists or facilities.
Schedule cancel or reschedule referral-related appointments according to guidelines.
Monitor referrals through completion including follow-up and obtaining specialist reports.
Verify patient insurance eligibility and coverage for referred services.
Obtain prior authorizations for visits procedures diagnostics or medications.
Coordinate communication with insurance payors.
Accurately document all referral activity in the EMR.
Scan and upload referral-related records.
Keep patient charts updated and organized.
Inform patients of referral status appointment details and required steps.
Provide guidance on specialist locations insurance expectations and next steps.
Answer calls and in-person inquiries professionally.
Take and route clear accurate messages according to clinic protocols.
Ensure records and referral documentation are available in the chart before appointments.
Verify insurance and forms as needed.
Document no-shows in the EMR when necessary and follow clinic procedures for follow-up.
Work closely with providers nursing staff the front office and the business office.
Provide coverage or assistance to front office operations when needed.
Maintain a patient-centered approach with excellent customer service.
Uphold confidentiality standards and follow HIPAA guidelines.
Adapt to varying shifts or extended hours based on clinic needs.
Adjust responsibilities as workload or patient volume changes.
Perform additional tasks or projects assigned by clinic leadership.
Required:
High school diploma or equivalent.
Preferred:
None.