Referral Specialist

Duties/Responsibilities

• Navigate and manage patient charts and clinical documentation within Epic EMR.
• Cook up and coordinate referrals and imaging orders using Epic and insurance portals.
• Verify eligibility and obtain prior authorizations/pre-certifications as needed.
• Route/fax medical documentation electronically and retrieve reports via RHIO.
• Track referral status and assist patients with scheduling appointments.
• Follow up on missed referral/imaging appointments.
• Communicate appointment details and preparation requirements to patients.
• Collaborate with Care Managers and other departments to resolve barriers.

Required Skills/Abilities

• Proficiency in Epic EMR and Microsoft Office Suite.
• Strong knowledge of medical terminology and HIPAA regulations.
• Excellent customer service, organizational, and time management skills.
• Ability to multi-task and problem-solve effectively.
• Strong written and verbal communication skills; bilingual preferred.

Education and Experience

• A High School Diploma or equivalent required.
• Minimum 3 years in a medically based or human services setting.
• At least 2 years of EMR experience; Epic required.
• Knowledge of insurance carriers, prior authorizations, and community resources.
• Valid NYS Insurance Assister certificate preferred (or obtain within 6 months).

Physical Requirements

• While performing the duties of this job, the employee is regularly required to sit, stand, walk, and communicate effectively.
• Occasional bending, lifting up to 25 pounds, and other physical activities may be required.