Referral Specialist

Job Description

Job Description

Job Title: Referral Specialist Job Description

The Referral Specialist processes and coordinates internal and external referrals to specialty providers, ensuring timely and accurate completion of all referral-related activities. This role verifies insurance coverage, obtains prior authorizations, and maintains thorough documentation in the electronic health record system to support seamless patient care coordination. The Referral Specialist collaborates closely with clinical and administrative teams to manage high referral volumes in a fast-paced environment while providing clear communication to patients, providers, and specialty offices.

• Process and coordinate internal and external referrals to specialty providers in a timely and accurate manner.
• Verify insurance coverage for patients and obtain prior authorizations as required by health plans and managed care organizations.
• Submit referral requests to health plans, independent practice associations (IPAs), or specialty offices and track status updates through completion.
• Ensure all supporting documentation, including chart notes, laboratory results, and imaging reports, is complete and attached to each referral.
• Communicate referral status and any updates clearly and professionally to patients, providers, and specialty offices.
• Maintain accurate and up-to-date documentation in the electronic health record (EHR) or electronic medical record (EMR) system for all referrals and authorizations.
• Follow up on pending referrals to meet established turnaround times and ensure completion of the referral process.
• Collaborate with front office staff, back office staff, and providers to support effective patient care coordination and resolve referral-related issues.
• Manage a high volume of referrals daily while maintaining organization, accuracy, and adherence to referral workflows.
• Apply medical terminology and knowledge of medical records to accurately interpret and process referral documentation.

• Previous experience in referrals, authorizations, or a medical office setting preferred.
• Strong understanding of insurance types, including HMO, PPO, and Medi-Cal, and related referral workflows.
• Experience working with EMR/EHR systems to enter, track, and update referral information.
• Proficiency with medical terminology and medical record documentation.
• Knowledge of prior authorization processes and managed care requirements.
• Familiarity with Medicaid programs and guidelines.
• Strong organizational skills with the ability to manage high referral volumes in a fast-paced environment.
• Ability to handle multiple referrals daily while maintaining accuracy and attention to detail.
• Effective communication skills to interact with patients, providers, and specialty offices.
• Solid project coordination skills to track and follow through on all referral-related tasks.

• Experience in a healthcare or clinical environment supporting patient care coordination.
• Demonstrated ability to work collaboratively in a team-oriented environment.
• Comfort with adapting to changing priorities and workflows as needed.
• Motivation to grow within the organization and develop professionally.

This is a full-time position with a Monday through Friday schedule from 8:00 a.m. to 5:00 p.m. The role operates in a fast-paced healthcare setting that relies heavily on electronic health record (EHR) and electronic medical record (EMR) systems for documentation and communication. The environment is team oriented, with close collaboration among front office staff, back office staff, and providers to support coordinated patient care. The position involves managing a high volume of referrals each day, requiring sustained focus, organization, and effective communication throughout the workday.

This is a Contract position based out of Buellton, CA.

The pay range for this position is $23.00 - $26.00/hr.

Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.

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 Buellton,CA.

This position is anticipated to close on Sep 18, 2026.

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 20,000 consultants and 5,000 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. We are proud to be an Engineering News-Record (ENR) Top 500 Design Firm for our engineering design services and a ClearlyRated Best of Staffing® winner for both client and talent service.

The company is an equal opportunity employer and will consider all applications withoutregard to race, sex, age, color, religion, national origin, veteran status, disability,sexual orientation, gender identity, genetic information or any characteristic protectedby law.

If you would like to request a reasonable accommodation, such as the modification oradjustment of the job application process or interviewing process due to a disability,please email View email address on ziprecruiter.com for other accommodation options.

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

Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as acondition of employment or continued employment. An employer who violates this lawshall 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 applicationsand qualifications, but final decisions are made by our hiring team. By applying, youacknowledge and agree that your application may be reviewed using AI tools.