Patient Access Rep 2 - Pulmonology Clinic

Overview Employer paid benefits - Medical, Dental, and Vision Hourly Rate: Min: $19.85 Max: $30.40 The Referral Coordinator is a vital member of the care coordination team, responsible for managing all aspects of the referral process to ensure patients receive timely access to specialty care, diagnostic testing, procedures, or medications. This role works collaboratively with providers, medical assistants, front office staff, and business office personnel to ensure prior authorizations are obtained, insurance requirements are met, and complete and accurate documentation is maintained within the electronic medical record (EMR). The Referral Coordinator facilitates the flow of information between internal teams and external specialists, ensuring that all referral appointments are properly scheduled, authorized, and communicated to patients. Responsibilities also include verifying insurance eligibility, preparing and scanning records, managing phone and EMR messages, and maintaining accurate and timely updates in the patient chart. This position plays a critical role in delivering seamless patient experience and supporting overall clinic operations through efficient referral coordination and communication. Additional tasks may be assigned by the Practice Manager as needed. Responsibilities Essential Job Functions : Referral Management: Coordinates all inbound and outbound referrals by reviewing provider orders, initiating referral requests, and ensuring necessary documentation (chart notes, imaging, labs, etc.) is submitted accurately to the receiving specialist or facility. Scheduling & Follow-Up: Correctly schedules, cancels, or reschedules referral-related appointments according to practice guidelines, either by phone or in person. Tracks the status of referrals to completion, including follow-up appointments and specialist feedback. Insurance Verification & Prior Authorizations: Verifies patient insurance eligibility and coverage for referred services. Obtains prior authorizations when required for procedures, specialty visits, diagnostics, or medications, and communicates effectively with insurance payors. Electronic Medical Record (EMR) Management: Accurately documents all referral activity and communication in Epic (or other EMR), ensuring documentation is current, complete, and accessible for care teams. Scans referral-related documents and updates records as needed. Patient Communication: Informs patients of referral status, appointment details, and any required steps or documentation. Acts as a resource for patients regarding specialist locations, insurance requirements, and next steps in the care process. Message Handling: Answers incoming calls and responds to in-person inquiries with professionalism. Takes clear and complete messages following clinic protocols and ensures timely delivery to the appropriate staff member or provider. Chart Preparation & Support (Clinic Dependent): In some clinics, Referral Coordinators may support chart prep by ensuring medical records and referral documentation are available in the chart at the time of appointment, including verifying forms and insurance status. This may vary depending on clinic size and workflow structure. No-Show Documentation: Documents appointment no-shows in Epic if front desk staff are unavailable, following clinic procedures for follow-up and continuity of care. Team Collaboration: Works closely with providers, nursing staff, front office, and the business office to support seamless care coordination. Provides coverage or assistance to the front office when needed and promotes a collaborative team environment. Customer Service & Confidentiality: Maintains a patient-first approach by delivering excellent customer service while adhering to AIDET communication principles and HIPAA privacy standards. Work Schedule Flexibility: Must be flexible and available to work various shifts, including extended evening hours or weekends, based on clinical needs. Adjustments to hours or responsibilities may be required as workload or patient volume fluctuates. Other Duties as Assigned: Performs additional tasks or projects as directed by the Practice Manager or clinic leadership to support clinic operations and ensure timely, coordinated care delivery. The employee supports the hospital mission, vision, values, policies, and procedures. Participates in required education for DNV programs as applicable to position (reference program education curriculum). Performs other related duties as assigned. Qualifications Education Required: High school diploma or equivalent. Must provide copy upon hire. Preferred: NA Licenses/ certifications/ registrations Required: NA Preferred: NA Experience Required: Minimum of 1–2 years of experience in a medical office or clinic setting. Familiarity with insurance verification, scheduling, and patient communication. Experience working with electronic medical records (Epic preferred). Preferred: Prior experience specifically in referral coordination, prior authorization, or front office lead role. Knowledge of insurance payor requirements and referral workflows across multiple specialties Other: Skills and Knowledge: Proficient in office technologies including EMR systems, Microsoft Office, phone systems, scanners, and fax machines Working knowledge of medical terminology, insurance coverage guidelines, and HIPAA regulations Strong understanding of documentation, chart prep, and prior authorization processes Ability to communicate clearly and professionally with patients, providers, staff, and external offices Highly organized and detail-oriented with the ability to manage multiple priorities in a fast-paced environment Personal Traits and Aptitudes: Demonstrates a compassionate, respectful, and patient-centered demeanor Works both independently and as part of a collaborative care team Maintains professionalism, confidentiality, and accuracy under pressure Culturally sensitive and able to work effectively with diverse populations Other Requirements: CPR certification may be required per clinic policy Bilingual (English/Spanish) strongly preferred but not required for patient communication and support Must be flexible with schedule and available to adjust hours as needed based on clinic demand Physical Requirements: Prolonged periods of sitting at a desk and working on a computer. Occasional walking, standing, bending, or lifting light office items (up to 25 pounds). Visual acuity to view computer screens and read detailed financial documents. Ability to communicate effectively in person, by phone, and electronically. May be required to move throughout the healthcare facility, including administrative and clinical areas. Working Conditions: This position operates in a professional office setting within a healthcare facility. The role routinely uses standard office equipment such as computers, phones, photocopiers, and filing cabinets. The office environment is climate-controlled, well-lit, and ergonomically designed for extended computer work. While this role is primarily office-based and does not involve direct patient care, the employee may occasionally be present in clinical areas or interact with staff working in clinical environments. As such, there is a potential for exposure to infectious diseases. The organization provides appropriate training and personal protective equipment (PPE) as needed to ensure safety. #J-18808-Ljbffr