Lead Referral Coordinator

Lead Referral Coordinator

At Claremedica, exceptional is the standard. Driven by our purpose to enhance the lives of the seniors in the communities where we have the privilege to work, live, and play, the Claremedica team is comprised of the brightest and best in their fields of expertise. From clinical excellence to unparalleled administrative support and beyond, we're working together to help seniors live happier, healthier, fuller lives. That kind of teamwork and passion for excelling can only exist in a workplace that fosters employees' growth and wellness and where their full potential and value are realized. At Claremedica, we're excited about great people like you. We're even more excited to support you with the resources, training, benefits, competitive compensation, and more to help you thrive and succeed in our communities. Opportunity awaits welcome to Claremedica.

The Lead Referral Coordinator is a senior-level role responsible for overseeing the referral coordination team and ensuring consistent, high-quality support for patients and providers. In addition to managing the most complex referral cases, this position provides training and guidance to team members, monitors workflow and compliance with referral protocols, and serves as the primary liaison between referral staff and clinic leadership. Lead Referral Coordinators play a key role in maintaining efficiency, resolving escalated issues, and fostering a collaborative team environment that supports seamless patient care.

Duties and responsibilities include:

• Oversee the referral coordination team, ensuring efficient workflow and adherence to referral protocols.
• Manage the most complex or escalated referral cases, including those requiring extensive insurance approvals or multi-specialty coordination.
• Train, mentor, and support Referral Coordinators I and II, providing guidance on processes and problem-solving strategies.
• Serve as liaison between referral staff, providers, and clinic leadership to improve referral processes and resolve systemic challenges.
• Monitor referral documentation, timeliness, and compliance to maintain quality and patient safety standards.
• Advocate for patients when navigating the healthcare system, financial barriers, or insurance requirements.
• Build and maintain relationships with specialists, community resources, and service providers to streamline referral processes.
• Review referral reports and tracking metrics, providing feedback to leadership on opportunities for improvement.
• Perform administrative and supervisory tasks as assigned by the Referrals and Medical Records Manager or clinic leadership.

Qualifications/requirements include:

• Education: High school diploma, GED, or equivalent experience (required). Advanced training, certifications, or coursework in healthcare administration, management, or related fields preferred.
• Experience: Minimum 3 years of experience in referral coordination, healthcare administration, or a related role, including supervisory or team lead responsibilities. Demonstrated proficiency with healthcare systems and EMR platforms required.
• Knowledge: In-depth knowledge of HIPAA and AHCA regulations, medical terminology, referral processes, products, services, standards, policies, and procedures. Expertise in insurance authorizations, prior approvals, and complex case management. Familiarity with workflow management, quality assurance, and team leadership in a clinical setting.
• Skills: Exceptional communication, leadership, organizational, and problem-solving skills. Ability to manage escalated cases, mentor staff, coordinate workflow, and ensure team compliance under high-volume conditions. Highly detail-oriented with strong accuracy in data, documentation, and reporting.
• Technical Proficiency: Advanced proficiency in Microsoft Office Suite, EMR systems, and other healthcare technology. Ability to train and support staff on technical systems and workflow processes.
• Leadership: Prior supervisory experience for external candidates, or demonstrated leadership aptitude and competency for internal promotion candidates.
• Additional: Professional and courteous communication with patients, providers, staff, and external partners. Bilingual (English/Spanish or English/Creole) preferred. Strong leadership and mentoring capabilities, fostering a collaborative and efficient team environment.

Working conditions include general office working conditions. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential function. While performing the duties of this job, the employee will be required to stand, walk, sit, use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs, balance; stoop, kneel, crouch or crawl; talk or hear. The employee must occasionally lift and or move up to 15 pounds. Specific vision abilities required by the job include close vision, distance vision, peripheral vision, depth perception, and the ability to adjust your focus. Manual dexterity is required to use desktop computers and peripherals.

The work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of his job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.

Local travel between care centers may be required for coverage. Minimal hazards.