Referral Coordinator

About the Role

A Referral Coordinator in a nonprofit healthcare setting manages the coordination of patient referrals to ensure timely access to medical, behavioral health, and social support services. This role serves as a liaison between patients, providers, specialists, and community-based organizations, facilitating accurate documentation, insurance verification, appointment scheduling, and follow-up care. The Referral Coordinator maintains compliance with organizational policies and regulatory requirements while prioritizing patient-centered care, particularly for underserved populations. By tracking referral outcomes, addressing barriers to care, and collaborating with interdisciplinary teams, the Referral Coordinator helps improve care continuity, health outcomes, and overall service efficiency.

Responsibilities

• Coordinate and process medical referrals for services not provided within the clinic, ensuring timely access to specialty and ancillary care.
• Facilitate specialty care referrals, including scheduling appointments and communicating with external providers and partners.
• Obtain, track, and manage pre-authorizations in accordance with payer and managed care requirements.
• Maintain accurate and up-to-date referral documentation and electronic patient tracking systems.
• Provide appointment reminders and ensure patients receive copies of approved referrals and necessary documentation.
• Coordinate pre-operative orders with external clinics and schedule required appointments within the organization.
• Monitor referral status and follow up with patients, providers, and payers to ensure completion of services.
• Ensure compliance with organizational policies, payer guidelines, and regulatory requirements related to referrals and authorizations.
• Serve as a liaison between patients, providers, and external partners to support continuity of care.
• Identify and address barriers to care, supporting patients in navigating the referral process effectively.

Requirements

• High School diploma or equivalent.
• Current Medical Assistant certificate or one year of Referral Coordinator experience may substitute for the Medical Assistant certificate.
• One year of experience working in a community clinic or other medical office is required.
• Good verbal and written communication skills.
• Ability to work in a diverse environment and handle multiple tasks simultaneously.
• Familiarity with electronic medical records preferred.

Skills

• Referral coordination and specialty scheduling.
• Insurance verification and prior authorization management.
• EHR and referral tracking system proficiency.
• Strong attention to detail and documentation accuracy.
• Effective communication and customer service skills.
• Organization, multitasking, and time management.
• Follow-up and referral status tracking.
• Problem-solving and critical thinking.
• Knowledge of medical terminology and workflows.
• HIPAA compliance and confidentiality.
• Team collaboration and coordination.
• Adaptability in a fast-paced environment.
• Bilingual (English/Spanish).

Physical Requirements

• Occasional light lifting up to 25 pounds, and some bending, stooping, or squatting.
• Considerable walking may be involved.
• Ability to sit or stand for extended periods of time.
• Flexibility to work in multiple locations throughout the week.
• Finger dexterity and hand coordination required.
• Specific vision abilities: close vision, distance vision, ability to adjust or focus.

Work Environment

• Exposure to adverse conditions, extreme heat, cold, wet and/or humid conditions.
• Exposure to moving mechanical parts, high or precarious places, fumes, airborne particles, toxic or caustic chemicals, outside weather conditions, and possible risk of electrical shock.
• Exposure to explosives, possible risk of radiation, and vibration.
• Protective clothing or equipment required, including gloves, helmets, steel-toed boots, and protective eyewear.
• High noise levels in the work environment.