REFERRAL COORDINATOR - AMBULATORY CARE MANAGEMENT

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Position Overview The Referral Coordinator manages patient referrals from the time an order is placed through completion. This role works with patients, providers, insurance plans, and outside specialists to coordinate appointments, obtain required authorizations, send supporting medical records, track referral status, and ensure consultation notes or results are returned to the clinic. The Referral Coordinator helps reduce delays in care and keeps the clinical team informed of outstanding or completed referrals.

Key Responsibilities Review and process referral orders from providers in a timely manner.

Verify patient demographics, insurance coverage, network requirements, and referral or prior authorization requirements.

Obtain prior authorizations when required and document authorization numbers, effective dates, and status in the electronic health record.

Send referral orders, clinical notes, laboratory results, imaging, and other supporting documentation to receiving organizations.

Assist patients with referral scheduling and provide clear information about next steps, location, preparation, and required documentation.

Obtain consultation notes, diagnostic reports, and other referral results and route them to the ordering provider for review.

Document referral activity, patient communication, authorization status, and completion in the electronic health record.

Follow up on missed, delayed, denied, or incomplete referrals and elevate barriers or urgent concerns to the appropriate clinical team member.

Communicate with providers, medical assistants, front office staff, patients, insurance plans, and external partners to support continuity of care.

Maintain patient confidentiality and follow HIPAA, clinic policies, and established referral workflows.

Participate in staff meetings, training, and quality improvement activities related to referral completion and access to care.

Knowledge & Skills Knowledge of healthcare referrals, insurance verification, prior authorization processes, and medical terminology.

Ability to communicate clearly and professionally with patients, providers, insurance plans, and outside medical offices.

Attention to detail and accuracy in documentation, insurance information, and referral tracking.

Ability to identify barriers to referral completion and coordinate appropriate follow-up.

Proficiency with computers, Microsoft Office, payer portals, and electronic health record systems. Ability to handle confidential information and follow HIPAA requirements.

Bilingual English/Spanish preferred.

Qualifications At least one year of experience in a medical office, referral coordination, prior authorization, patient access, scheduling, or similar healthcare role preferred.

Experience working with insurance plans, specialist offices, and electronic health records preferred.

Experience in an outpatient clinic, primary care, or community health setting preferred.

Educational/ Licensure Requirements High school diploma or GED required.

Remain seated and work at a computer for extended periods.

Use a computer, keyboard, mouse, and telephone regularly.

Communicate effectively in person, by telephone, and via video conferencing.

Occasionally stand, walk, bend, reach, and lift office materials.

Travel locally or overnight, if required by the position.

20 - $25 – Hourly

Health Insurance

Dental

Employee Assistance Program – EAP

Paid holidays

Floating Holidays