Referral Specialist
About the role
The Referrals Specialist acts as a key liaison between patients, providers, healthcare facilities, and community agencies. They coordinate outgoing referrals, specialty appointments, and radiology/imaging services, ensuring timely access to care. The role involves managing referral processes within the Epic Electronic Medical Record (EMR) system, verifying insurance eligibility, obtaining authorizations, and tracking referral status. They review medical documentation, facilitate appointment scheduling, and follow up on missed visits to support continuity of care.
Responsibilities
- Navigate and manage patient data in Epic EMR, including referrals and authorizations.
- Coordinate specialty and imaging services, verifying insurance and obtaining prior authorizations.
- Utilize health information exchange systems to gather medical reports.
- Ensure accurate documentation using medical terminology and maintain HIPAA compliance.
- Assist patients with scheduling and follow-up activities to resolve missed appointments.
- Support quality improvement initiatives and maintain confidentiality of sensitive information.
Qualifications
- Minimum two years in healthcare or human services, with one year EMR experience.
- High school diploma or equivalent; certification in insurance assistance is a plus.
Skills
- Strong customer service, organizational, and multitasking skills.
- Knowledge of healthcare referral workflows, insurance processes, and community resources.
- Excellent communication skills; bilingual abilities preferred.
- Proficiency with Microsoft Office; experience with Epic EMR highly preferred.
- Medical terminology knowledge and understanding of HIPAA regulations.
Requirements
Ability to work independently and collaboratively, with physical ability to perform routine tasks such as sitting, standing, and lifting up to 25 pounds. The role emphasizes adherence to confidentiality and quality standards to support accessible, high-quality patient care.