Referral Specialist

Referral Specialist

Pagosa Springs Medical Center - Pagosa Springs, Colorado (Remote/hybrid may be considered based on departmental needs.)

Position Highlight

Help ensure patients receive timely access to specialty care by coordinating referrals, insurance authorizations, and communication between providers, patients, and specialty clinics.

Position Summary

Pagosa Springs Medical Center (PSMC) is seeking a detail-oriented and patient-focused Referral Specialist to join our Rural Health Clinic team.

The Referral Specialist serves as a vital link between patients, primary care providers, specialty providers, and insurance carriers. This role is responsible for processing referrals, verifying patient and insurance information, coordinating required documentation, obtaining authorizations when needed, and tracking referrals from initiation through completion. The Referral Specialist helps ensure patients experience a seamless transition of care while maintaining accurate documentation within the electronic health record.

Why Join PSMC?

• Make a meaningful impact by helping patients access the specialty care they need
• Work closely with providers, nursing staff, and specialty offices
• Be part of a collaborative team committed to outstanding patient care
• Develop expertise in referral coordination, insurance authorization, and care management
• Enjoy a flexible part-time opportunity within a supportive rural healthcare organization

Key Responsibilities

Referral Coordination

• Process referrals from primary care and specialty providers using the electronic health record and referral management platform
• Verify patient demographics, insurance information, and referral requirements
• Compile and transmit clinical documentation, laboratory results, imaging, and other required records to receiving providers
• Monitor referral status from initiation through completion
• Follow up on outstanding referrals to ensure timely patient care
• Document all referral activity accurately within the electronic health record and referral management system

Insurance & Authorization

• Verify insurance coverage and referral requirements
• Obtain prior authorizations for services when required
• Monitor authorization expiration dates and obtain renewals as appropriate
• Ensure all required testing and documentation are completed prior to referral processing
• Maintain knowledge of referral requirements for commonly utilized specialty providers

Patient & Provider Communication

• Communicate referral status with patients, providers, nursing staff, and specialty offices
• Respond to patient phone calls, voicemail messages, and patient portal communications in a timely manner
• Assist patients with questions regarding the referral process
• Communicate changes in referral requirements to clinic staff
• Coordinate care with the VA and other external organizations as appropriate

Care Coordination

• Collaborate with providers and clinic leadership to ensure continuity of care
• Manage referral worklists and patient population lists
• Assist with patient outreach, scheduling, and coordination activities
• Monitor incoming referral faxes and electronic referrals
• Support quality initiatives and population health activities

Administrative Support

• Utilize electronic fax systems and electronic health records efficiently
• Scan and upload documents into patient records
• Maintain accurate documentation using approved workflows and abbreviations
• Assist providers and clinic staff with referral-related questions and processes
• Participate in departmental training, quality improvement initiatives, and ongoing professional development

Qualifications

Education

• High school diploma or equivalent required

Experience

• Minimum of two (2) years of experience in a clinical setting preferred
• Previous outpatient clinic or physician office experience preferred
• Previous clinical experience preferred but not required
• Previous electronic medical record (EMR) experience preferred

Licensure & Certifications

• Current AHA BLS (Heartsaver) certification required
• Strong computer proficiency, including Microsoft Office and electronic health records

Skills

• Excellent organizational and time management skills
• Strong attention to detail and accuracy
• Outstanding customer service and communication skills
• Ability to manage multiple priorities in a fast-paced environment
• Critical thinking and problem-solving abilities
• Ability to work independently while collaborating effectively with providers and clinical staff
• Experience with Cerner or other electronic health records preferred

What We're Looking For

The ideal candidate:

• Enjoys helping patients navigate the healthcare system
• Thrives in a fast-paced, detail-oriented environment
• Is highly organized and proactive
• Builds positive relationships with patients, providers, and community partners
• Demonstrates professionalism, compassion, and accountability
• Embodies PSMC's WISER values of Wholeness, Integrity, Stewardship, Excellence, and Respect

Compensation & Benefits

• Base Compensation Range: $18.00 - $22.38 hourly, based on years of relevant experience.
• Benefits include generous paid time off, separate sick leave, health, dental, vision, life and AD&D insurance, long-term disability and option for short-term disability, and retirement plan with employer contribution.
• Job Type: Full-time
• Shift Type: Weekdays
• Anticipated End Date for Posting: September 18, 2026. The deadline may close sooner due to an unanticipated business necessity, such as an incumbent vacating the role earlier than anticipated. You are encouraged to apply well in advance of the deadline.

Pagosa Springs Medical Center is an Equal Opportunity Employer. All qualified applicants will be considered for employment, and we will not discriminate against any person on the basis of race, color, national origin, disability, age, sex, religion, creed, ancestry, sexual orientation, marital status, or any other characteristic protected by law. Offers of employment are contingent upon successful completion of a pre-employment health and drug screen and background check.

About Pagosa Springs Medical Center

Pagosa Springs Medical Center is a Critical Access Hospital serving Pagosa Springs and Archuleta County in southwest Colorado. Our Rural Health Clinic is committed to providing high-quality, patient-centered care while helping patients access specialty services as efficiently as possible.

Located in the beautiful San Juan Mountains, Pagosa Springs offers an exceptional quality of life with world-class hiking, skiing, fishing, mountain biking, rafting, hunting, and the world's deepest geothermal hot springs. At PSMC, you'll join a collaborative team guided by our WISER values: Wholeness, Integrity, Stewardship, Excellence, and Respect, where every team member plays an important role in improving the health of our community.

Apply Today

If you're a detail-oriented healthcare professional who enjoys coordinating care, solving problems, and helping patients navigate the healthcare system, we'd love to hear from you. Join Pagosa Springs Medical Center and play an important role in connecting our patients with the specialty care they need.