Job Summary
The Referral Coordinator supports timely access to specialty care and other services by coordinating, processing, tracking, and following up on patient referrals. This position is designated for clinics with a high volume of incoming and/or outgoing referrals that requires dedicated administrative coordination. The Referral Coordinator works closely with patients, clinical staff, specialty offices, insurance carriers, and other community partners to help ensure referrals are complete, appropriately authorized, scheduled, and documented. As operational needs require, the Referral Coordinator also provides support coverage for medical reception functions in accordance with the responsibilities and expectations outlined in the Medical Receptionist job description.
Supervisory Responsibilities
This position has no supervisory responsibilities.
Essential Job Functions / Responsibilities
Referral Coordination
- Processes incoming and outgoing referrals accurately and within established timeframes.
- Reviews referral requests for completeness and obtains missing clinical, demographic, insurance, or other required information.
- Coordinates with providers, clinical staff, patients, specialty practices, hospitals, and community organizations to facilitate referral completion.
- Determines whether prior authorization, insurance approval, or additional documentation is required and completes or facilitates the necessary steps.
- Sends required records and supporting documentation to the receiving organization using approved and secure methods.
- Assists patients with referral-related questions, scheduling requirements, and next steps.
- Tracks referrals from initiation through completion and follows up on referrals that remain pending, unscheduled, or incomplete.
- Obtains and appropriately routes consultation notes, test results, and other documentation received following a referral.
- Maintains accurate and timely referral information in the electronic health record and other applicable systems.
- Identifies referral barriers and communicates concerns to the appropriate provider, clinical team member, supervisor, or patient.
- Prioritizes urgent and time-sensitive referrals according to established procedures.
- Maintains working knowledge of referral requirements, insurance processes, specialty resources, and community services.
- Supports referral work queues, reports, and other processes used to monitor access, timeliness, and referral closure.
- Protects patient confidentiality and handles protected health information in accordance with organizational policies and applicable laws.
Medical Reception Support
- Provides medical reception coverage during absences, vacancies, scheduled breaks, periods of increased demand, or other operational needs.
- Performs assigned reception responsibilities in accordance with the Medical Receptionist job description, established workflows, and clinic procedures.
- May assist with greeting and checking in patients, answering and routing telephone calls, scheduling appointments, updating patient information, collecting required forms, and supporting general front-office operations.
- Maintains proficiency in essential medical reception processes to ensure effective coverage when needed.
High-Volume Clinic Designation
This position is intended for clinics where referral volume, complexity, or follow-up requirements exceed what can reasonably be incorporated into the routine responsibilities of medical reception or clinical support staff. Continued designation of a dedicated Referral Coordinator may be evaluated based on referral volume, operational needs, clinic size, specialty mix, and workflow requirements.
Additional Responsibilities
- Communicates respectfully and professionally with patients, colleagues, providers, and external partners.
- Participates in team meetings, training, process improvement activities, and required organizational education.
- Helps identify opportunities to improve referral workflows, patient communication, and referral completion rates.
- Maintains reliable attendance and adapts to changing clinic priorities and coverage needs.
- Performs other duties consistent with the position as assigned.
The above statements are intended to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated here
Position Qualifications
- High school diploma or equivalent required.
- Previous experience in a medical office, referral, scheduling, patient access, or healthcare administrative role preferred.
- Experience with electronic health records and insurance authorization processes preferred.
- Knowledge of medical terminology preferred.
- Strong organizational skills and demonstrated ability to manage a high volume of detailed, time-sensitive work.
- Strong written, verbal, and interpersonal communication skills.
- Ability to maintain confidentiality and exercise sound judgment.
- Ability to work independently while collaborating effectively with a multidisciplinary team.
- Ability to provide medical reception coverage and perform the essential responsibilities outlined in the Medical Receptionist job description.