Medical Referral Specialist

Medical Referral Specialist

We currently have an exciting new opportunity for a full-time Medical Referral Specialist in our busy multi-specialty Clinic. The Medical Referral Specialist coordinates patient access to specialists by verifying insurance, obtaining pre-authorizations, scheduling appointments, tracking referrals in EHRs, and acting as a liaison between patients, providers, and insurers, ensuring continuity of care and adherence to insurance policies while maintaining accurate records and communicating progress. Key duties involve insurance verification, coordinating care, patient education, and administrative tasks like documentation and follow-up, requiring strong communication, organization, and knowledge of medical terminology and insurance processes.

We are in search of a team player that has the following:

• Verify patient eligibility, benefits, and obtain pre-authorizations or pre-certifications from insurance companies.
• Act as liaison between patients, referring to providers, specialists and health plans.
• Schedule appointments with specialists, DME providers, or for diagnostic tests.
• Maintain meticulous records in the Electronic Health Record (EHR), track referral status, and close the referral loop.
• Educate patients on their healthcare plan, confirm appointments, and provide reminders.
• Monitor referral progress, ensure timely completion, and follow-up with all parties.
• Generate reports on referral trends and assist with quality improvement initiatives.
• Performs other duties as assigned.

Requirements:

• High school diploma or equivalent required.
• Minimum of 3 to 5 years of experience working in a medical setting.
• Strong knowledge of medical terminology.
• Good command of English oral and written. (Bilingual Spanish preferred)
• Knowledge of EMR, Microsoft Office or other computer systems.
• Leadership, problem-solving, and conflict resolution.
• Excellent communication and interpersonal skills.
• Current CPR/First Aid card.
• Current TB negative test.
• Excellent customer service skills.
• Attention to detail and accuracy.
• Self-motivated, responsible, reliable and honest.
• Must be a team-player who interacts well with others.

We offer an exceptional benefits package, which includes medical, dental and vision. Our team of highly qualified physicians and staff will also provide you with exceptional training and mentorship for your career.