Referral Specialist

Job Details Job Location: Ann Arbor, MI 48108 Position Type: Full Time Education Level: High School/GED Travel Percentage: None Job Shift: Day Job Category: Health Care Essential Functions Must be on site twice a week and reside locally. Receive, review, and process provider-initiated referrals to specialty and ancillary services. Verify insurance eligibility and determine prior authorization requirements. Prepare and submit complete referral documentation to payers or external providers. Communicate with specialists, imaging centers, and hospitals to schedule and confirm patient appointments. Follow up on pending or incomplete referrals to ensure timely completion. Document all referral activity in the electronic health record (EHR), ensuring accuracy and completeness. Notify patients of referral status, authorization approvals, and appointment details. Provide assistance and education to patients regarding the referral process, coverage limitations, or community resources. Help identify and resolve barriers to care, such as transportation or communication challenges. Collaborate closely with medical providers, care managers, and front desk staff to support continuity of care. Maintain effective communication with external specialists and ensure clinical information is exchanged as needed. Track and close referral loops, ensuring that results and consult notes are received and routed to the ordering provider. Adhere to payer, FQHC, and HIPAA regulations regarding documentation and patient confidentiality. Support quality improvement efforts related to referral completion and care coordination. Participate in training, team meetings, and workflow improvement initiatives. Maintain exemplary customer service. Qualifications High school diploma or equivalent required; associate degree in healthcare administration or related field preferred. Minimum 2 years of experience in a medical office or health system performing referral coordination, scheduling, or prior authorizations. Experience in an FQHC, community health center, or primary care setting strongly preferred. Knowledge of insurance plans, authorization requirements, and referral workflows. Proficiency in Epic strongly preferred. #J-18808-Ljbffr