Referral Coordinator - Ophthalmology

Overview

Employer paid benefits include Medical, Dental, and Vision.

Responsibilities

• Coordinates all inbound and outbound referrals by reviewing provider orders, initiating referral requests, and ensuring necessary documentation is submitted accurately to the receiving specialist or facility.
• Schedules, cancels, or reschedules referral-related appointments according to practice guidelines, either by phone or in person.
• Tracks the status of referrals to completion, including follow-up appointments and specialist feedback.
• Verifies patient insurance eligibility and coverage for referred services. Obtains prior authorizations when required for procedures, specialty visits, diagnostics, or medications, and communicates effectively with insurance payors.
• Accurately documents all referral activity and communication in Epic (or other EMR), ensuring documentation is current, complete, and accessible for care teams.
• Scans referral-related documents and updates records as needed.
• Informs patients of referral status, appointment details, and any required steps or documentation. Acts as a resource for patients regarding specialist locations, insurance requirements, and next steps in the care process.
• Answers incoming calls and responds to in-person inquiries with professionalism. Takes clear and complete messages following clinic protocols and ensures timely delivery to the appropriate staff member or provider.
• Supports the hospital mission, vision, values, policies, and procedures. Participates in required education for DNV programs as applicable to position (reference program education curriculum).
• Performs additional tasks or projects as directed by the Practice Manager or clinic leadership to support clinic operations and ensure timely, coordinated care delivery.

Qualifications

• Education: High school diploma or equivalent. Must provide copy upon hire.
• Experience: Minimum of 1-2 years of experience in a medical office or clinic setting. Familiarity with insurance verification, scheduling, and patient communication. Experience working with electronic medical records (Epic preferred).
• Knowledge: Proficient in office technologies including EMR systems, Microsoft Office, phone systems, scanners, and fax machines. Working knowledge of medical terminology, insurance coverage guidelines, and HIPAA regulations. Strong understanding of documentation, chart prep, and prior authorization processes. Ability to communicate clearly and professionally with patients, providers, staff, and external offices. Highly organized and detail-oriented with the ability to manage multiple priorities in a fast-paced environment.
• Personal Traits: Demonstrates a compassionate, respectful, and patient-centered demeanor. Works both independently and as part of a collaborative care team. Maintains professionalism, confidentiality, and accuracy under pressure. Culturally sensitive and able to work effectively with diverse populations.

Other Requirements

• CPR certification may be required per clinic policy.
• Bilingual (English/Spanish) strongly preferred but not required for patient communication and support.
• Must be flexible with schedule and available to adjust hours as needed based on clinic demand.