Lead Referral Coordinator

Essential Functions

• 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

• Education: High school diploma, GED, or equivalent experience (required).
• 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.