Referral Coordinator I

Referral Coordinator I JOB DESCRIPTION

Job Title: Referral Coordinator

Reports to: Referral Manager/ Assistant Manager

Job Status: Full-time

FLSA Status: Non-exempt

Revised: 5.01.2025

Summary

The Referral Coordinator assists patients by scheduling appointments, sending reminders, and providing essential information regarding their visits. This role requires a detail-oriented and highly organized individual who proactively communicates referral statuses, updates, and other essential information to patients, healthcare providers, and internal staff. The Referral Coordinator is instrumental in ensuring the successful initiation, tracking, and closure of patient referrals.

Essential Functions

• Ensure current and standardized referral policies and workflows are followed.
• Maintain up-to-date and compliant patient records in accordance with applicable laws and regulations.
• Gather and verify insurance information by communicating with patients and insurance providers.
• Ensure that all patient information provided to referred specialists is accurate and complete.
• Prioritize and address referrals based on urgency in a timely manner.
• Act as the primary point of contact for patients and specialists regarding questions or concerns related to referrals.
• Assist in resolving issues or barriers to patient referrals.
• Maintain confidentiality and secure patient information by managing medical records and diagnostic/procedure coding appropriately.
• Consistently provide exceptional customer service through phone, email, and in-person interactions.
• Initiate timely communication with patients regarding appointment reminders, referral updates, or required documentation.
• Serve as the primary facilitator for patient feedback and complaints, and collaborate with the Referral Manager for resolution.
• Communicate effectively with all medical staff regarding referral inquiries.
• Demonstrate flexibility and adaptability as business needs evolve.
• Take ownership of responsibilities and seek opportunities to exceed patient and team expectations.
• Meet daily performance goals as defined by management.
• Maintain professionalism in conduct, appearance, and communication.
• Follow all company policies and report issues through the appropriate chain of command.
• Process incoming referral requests and ensure proper documentation and timely distribution to relevant departments or healthcare providers.
• Serve as the primary point of contact for notifying patients, healthcare providers, and specialists about the status of their referrals, appointments, and required follow-ups.
• “Closer” responsibilities: Oversee the successful conclusion of referral processes, ensuring all actions and appointments are completed.
• Referral Finalization: Secure specialist appointments, obtain authorizations, and confirm outcomes.
• Closing Communication: Confirm final appointment times or follow-ups with patients and providers.
• Status Updates: Ensure no open items remain on patient referrals; document completion thoroughly.

Education and Experience

• High School Diploma or GED required.
• Associate Degree; preferred.
• Medical Assistant Certification preferred.
• Minimum one (1) year of experience in medical field; preferred.
• Minimum one (1) year of experience in an administrative field or customer service role; preferred.

Knowledge, Skills, and Abilities

• Obtain new patient referral information from referring providers or directly from patients.
• Process new referral requests for authorization using e-referral applications and Nexgen EHR.
• Manage the full referral lifecycle from initiation to closure in assigned Work Queues (WQ).
• Review referral submissions for completeness and follow up as needed.
• Follow up on denied, deferred, or pending referrals, including communication with patients, specialists, IPAs, or agencies.
• Communicate through phone, email, in-person, or Epic (In Basket) to manage referral updates and inquiries.
• Verify patient eligibility and inform patients and external facilities about billing and scheduling procedures.

Work Environment

• Fast-paced environment with occasional high-pressure situations
• Environmentally controlled medical office environment
• Frequent interaction with a diverse population including team members, providers, patients, insurance companies and other members of the public.
• Physical Demands: Frequent sitting, writing, typing, grasping, and speaking. High call volume workflow. Lifting, carrying, pushing, and pulling up to 25 pounds. Frequent interaction with a diverse population including team members, providers, government officials, patients, insurance companies and other members of the public. Regular use of computer, keyboard, copy and fax machine and phone.