Specialty Referral Specialist

About the role

The Specialty Referral Coordinator is responsible for processing, tracking, and coordinating all outgoing and incoming specialty referrals ordered by or referred to CFHC providers. This role ensures that referrals are handled efficiently, accurately, and in a timely manner while maintaining excellent communication between providers, patients, and specialty offices.

Responsibilities

• Reviewing provider orders and initiate specialty referrals
• Verifying insurance coverage and authorization requirements for referred services
• Submit prior authorizations as needed and follow up with insurance companies
• Communicate with patients regarding referral status
• Ensure timely follow-up on pending referrals and update electronic medical records (EMR)
• Maintain accurate documentation of all referral communications and outcomes
• Cookordinate with case managers, providers, and specialists to expedite urgent referrals
• Track and report referral completion and patient follow-up data
• Ensure HIPAA compliance and confidentiality of patient records
• Respond to inquiries from patients and providers regarding the status of referrals

Qualifications

• Preferred: Certified and Registered Medical Assistants
• Required: High School graduate or GED
• Minimum 1–2 years of experience in a medical office, referral coordination, or healthcare administration
• Familiarity with insurance processes, prior authorization, and medical terminology
• Proficient in EMR systems and Microsoft Office Suite
• Strong organizational skills and attention to detail
• Excellent interpersonal and communication skills
• Able to multitask and work in a fast-paced environment

Skills

• Knowledge of basic medical terminology
• Knowledge of various insurance programs (example, Medicaid)
• Strong customer service focus
• Effective verbal and written communication skills
• Organized and able to manage competing priorities
• Resourcefulness in problem solving
• Able to take and follow through with delegated tasks
• Team oriented