Referrals Specialist

Referral Specialist

Position Overview

We are seeking a bilingual Referral Specialist to join a busy pediatric healthcare clinic in San Diego, CA. This individual will play a vital role in supporting patient access to care by coordinating referrals, obtaining insurance authorizations, scheduling specialty services, and maintaining accurate referral documentation. The ideal candidate will have experience working in a healthcare environment, strong knowledge of insurance eligibility and authorization processes, and a commitment to providing exceptional patient service.

Key Responsibilities

• Receive, review, and process referral and authorization requests accurately and efficiently while ensuring complete documentation.
• Coordinate and schedule referrals, specialty consultations, diagnostic testing, durable medical equipment (DME), and ancillary services as ordered by providers.
• Obtain insurance authorizations through phone, fax, email, payer portals, and other communication channels.
• Follow up on outstanding authorization requests and missing documentation to prevent delays in patient care.
• Verify patient eligibility, benefits, coverage requirements, and authorization criteria with various insurance plans.
• Manage referrals throughout the entire lifecycle, from initiation through completion and closure.
• Utilize EMR systems and multiple software applications to document patient information, track referrals, schedule services, and obtain authorizations.
• Communicate referral and authorization status updates to patients, providers, and internal healthcare teams.
• Review referral logs regularly and update records with appointment details, outcomes, and follow-up requirements.
• Confirm patient attendance at scheduled appointments and obtain specialist reports, visit notes, and test results as needed.
• Maintain professionalism and excellent customer service when interacting with patients, providers, and healthcare partners.
• Consistently meet productivity, quality, and turnaround time expectations.

Required Qualifications

• Fully bilingual in English and Spanish, including verbal and written communication.
• Minimum of 1 year of healthcare experience involving referral coordination, authorizations, or both front and back office responsibilities.
• Knowledge of insurance plans, eligibility requirements, benefits, and authorization guidelines.
• At least 2 years of customer service experience.
• Experience utilizing Electronic Medical Records (EMR) systems.
• Typing speed of at least 35 words per minute.
• High School Diploma or GED.

Preferred Qualifications

• Experience with Epic EMR.
• Medical Assistant Certificate or related healthcare training.
• Knowledge of coding and data processing practices.
• Experience working in a high-volume healthcare or call center environment.
• Familiarity with pediatric, specialty clinic, or managed care settings.

Skills

• Referral Intake & Management
• Insurance Authorizations
• Insurance Verification & Eligibility
• Appointment Coordination
• EMR Documentation
• Epic EMR
• Bilingual English/Spanish
• Customer Service
• Call Center Support
• Medical Records Management
• Provider & Patient Communication
• Time Management and Organization

Schedule & Work Environment

• Monday through Friday
• 8:00 AM to 5:00 PM
• 100% Onsite
• May provide coverage support at nearby clinic locations as needed

Experience Level

Intermediate Level

This opportunity is ideal for healthcare professionals with referral and authorization experience who enjoy coordinating patient care, working with insurance carriers, and ensuring patients receive timely access to needed services.

Job Type & Location

This is a Contract position based out of San Diego, CA.

The pay range for this position is $25.00 - $25.00/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)

This is a fully onsite position in San Diego,CA.

This position is anticipated to close on Aug 5, 2026.

About TEKsystems

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

About TEKsystems and TEKsystems Global Services

We’re a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We’re a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We’re strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We’re building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.