Referral & Health Information Coordinator

Job Description

Job Description

JOB PURPOSE:

The Referral & Health Information Coordinator functions under the supervision and guidance of the Referral Team Lead. The Health Information Coordinator requires direct patient communication, critical thinking, and problem-solving. This position works closely with the clinical staff and outside agencies to ensure timely processing, tracking, and follow-up of external and internal referrals. The Health Information Coordinator is also responsible for the timely processing of all internal and external medical record requests, radiology prior authorizations, and handling mail related to referral coordination and medical record requests.

Essential Job Functions include, but are not limited to:

1. Satisfies Core Competencies

• Accepts responsibility for meeting the standards of the professional, ethical, and relevant legislated requirements.

1. Care Coordination:

• Achieves customer/patient’s satisfaction by greeting and proactively attending to patient needs.
• Explains the details and expectations regarding the referral with patients.
• Serves as the system navigator and point of contact for patients and families. Patients and their families will have direct access for asking questions and raising concerns. May assume advocate role on the patient's behalf with the carrier to ensure approval of the necessary supplies/services for the patient in a timely fashion.
• Ensures that patient's primary care chart is up to date with information on specialist consults, hospitalizations and ER visits related to their health.
• Coordinates with the Health Information Management (HIM) staff to track the status of all provider reports on patients referred to hospitals, outside clinics and specialty providers.
• Responds to patient’s requests in a timely and efficient manner.
• Maintains confidentiality of patient’s information at work and off duty.
• Relays messages in a timely manner to appropriate health care providers.
• Assists in making patient appointments and placing necessary referrals in a timely manner.
• Maintains ongoing tracking and appropriate documentation on referrals to promote team awareness and ensure patient safety.
• Assembles information concerning patient's clinical background and referral needs. Follows referral guidelines, provide appropriate clinical information to specialist.
• Contacts appropriate agency/organization to ensure prior approval requirements are met. Present necessary medical information such as history, diagnosis and prognosis. Provide specific medical information to financial services to maximize reimbursement to the hospital and physicians.
• Ensures that an efficient system of communication and processing medical calls.

1. Mail Services:

• Sorting and categorizing mail and packages according to department.
• Maintaining records of deliveries made and tracking mail and packages as required.
• Ensuring the confidentiality and security of sensitive documents and packages.
• Process all incoming mail by opening, scanning, and validating each item in mail software.

1. Workforce Development:

• Responsible for maintaining up-to-date knowledge, skills, and abilities
  • Attends and participates in in-service, monthly staff meetings, continuing education offerings, community training events, conferences, and webinars as appropriate

Required Education:

• High school diploma or equivalent required.
• Completion of an accredited Medical Assistant program preferred.
• Certification as a Medical Assistant is optional.
• 1–2 years of experience as a Medical Assistant required.
• Experience in referral coordination, care coordination, or medical office workflows strongly preferred.
• Previous work in Health Information Management (HIM) or medical records processing is a plus.
• Familiarity with insurance authorization processes, specialist referrals, and clinical documentation preferred.
• Proficiency with electronic health records (EHR), scanning systems, and basic office software required.

Skills, Licensure, and Knowledge Requirements

• Experience as a Medical Assistant is required.
• Strong interpersonal and communication skills with the ability to interact professionally with patients, providers, and external agencies.
• Excellent organizational skills with the ability to prioritize tasks, multitask, and manage time effectively in FQHC setting.
• Ability to demonstrate cultural competence, empathy, and professionalism in all patient interactions.
• Strong critical thinking and problem-solving skills, especially when navigating insurance barriers, prior authorizations, and community resources.
• Proficiency in electronic health records (EHR) systems—experience with systems commonly used in FQHCs (e.g., NextGen, eClinicalWorks, Athena) preferred.
• Ability to maintain accurate records while ensuring compliance with HIPAA and FQHC regulatory requirements.
• Reliable, flexible, and able to adapt to a fast-paced, team-oriented environment.
• Knowledge of FQHC operations, including sliding fee scale processes, care coordination protocols, and community health workflows.
• Strong understanding of referral coordination, care management, and population health practices.
• Working knowledge of medical terminology, specialty care processes, and clinical documentation standards.
• Familiarity with insurance requirements for Medicaid, Medicare, and managed care plans commonly utilized by FQHC patients.
• Understanding of social determinants of health (SDoH) and how they affect access to care and follow‑through on referrals.
• Knowledge of Health Information Management (HIM) practices, including release of information, medical record requests, and documentation compliance.

Physical Demands :

The physical demands described here are representative of those that must be met by the employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.

• While performing the duties of this job, the employee is regularly required to stand, sit, talk, hear, and use hands and fingers to operate a computer and telephone keyboard reach.
• Specific vision abilities required by this job include close vision requirements due to computer work.

Light to moderate lifting is required.

Work Environment:

The work environment characteristics described here are representative of those the employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Moderate noise (i.e. business office with computers, phone, and printers, light traffic).
• Ability to work in a confined area.
• Ability to sit at a computer terminal for an extended period of time.
• Ability to lift up to 25 pounds

Travel or Special Requirements:

Driving during the workday, as well as local or out-of-state travel, may be required to perform job duties.

This job description includes the essential job functions and responsibilities of the job. I understand that it is not inclusive of every task inherent to the job. In addition, I understand that it may occasionally require assignment of tasks not specifically covered in this job description. Duties, responsibilities, and activities may change at any time with or without notice. I understand that I will comply with reasonable requests from my supervisor.