Referral Specialist

Job Title: Referral Specialist

Job Description

The Referral Specialist processes and coordinates internal and external referrals to specialty providers, ensuring patients receive timely and accurate access to needed services. This role manages insurance verification, prior authorizations, and referral documentation while maintaining clear communication with patients, providers, and specialty offices in a fast-paced medical office environment.

Responsibilities

• Process and coordinate internal and external referrals to specialty providers in an accurate and timely manner.
• Verify insurance coverage for each referral and obtain prior authorizations as required by health plans or IPAs.
• Submit referral requests to health plans, IPAs, or specialty offices and track status updates until completion.
• Ensure all supporting documentation, including chart notes, laboratory results, and imaging reports, is complete and attached to each referral.
• Communicate referral status, approvals, denials, and next steps clearly to patients, providers, and specialty offices.
• Maintain accurate and up-to-date documentation in the electronic health record (EHR) system for all referral activities.
• Follow up on pending referrals to meet required turnaround times and ensure referrals are completed and scheduled.
• Collaborate closely with front office, back office, and providers to support seamless patient care coordination.
• Manage a high volume of referrals daily while prioritizing tasks and maintaining attention to detail.
• Identify and resolve issues related to referral workflows, insurance requirements, or missing documentation by working with internal teams and external partners.

Essential Skills

• Experience in referrals, prior authorizations, or a medical office setting preferred.
• Strong understanding of insurance types, including HMO, PPO, and Medi-Cal, and related referral workflows.
• Proficiency with EMR/EHR systems and familiarity with medical terminology.
• Knowledge of managed care and Medicaid processes.
• Ability to review and work with medical records and supporting clinical documentation.
• Strong organizational skills with the ability to manage high referral volumes in a fast-paced environment.
• Effective project coordination skills to track and follow referrals through completion.
• Excellent verbal and written communication skills for interacting with patients, providers, and specialty offices.
• Ability to multitask, prioritize, and meet deadlines while maintaining accuracy and attention to detail.

Additional Skills & Qualifications

• Prior experience handling prior authorizations and referral processing in a healthcare setting.
• Familiarity with various health plans, IPAs, and specialty office referral requirements.
• Demonstrated ability to work collaboratively in a team-oriented environment.
• Strong problem-solving skills to address referral issues and insurance barriers.
• Comfort working with electronic systems, including EMR/EHR platforms and insurance portals.

Work Environment

This is a full-time, Monday through Friday position with a typical schedule of 8:00 a.m. to 5:00 p.m. The role is based in a medical office environment that is team-oriented and fast-paced, requiring frequent coordination with front office staff, back office staff, and healthcare providers. The position involves extensive use of electronic health record systems and insurance portals throughout the day, as well as phone and electronic communication with patients and specialty offices.

Job Type & Location

This is a Contract position based out of Buellton, CA.

Pay and Benefits

The pay range for this position is $23.00 - $26.00/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully onsite position in Buellton,CA.

Application Deadline

This position is anticipated to close on Jun 30, 2026.

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 20,000 consultants and 5,000 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. We are proud to be an Engineering News-Record (ENR) Top 500 Design Firm for our engineering design services and a ClearlyRated Best of Staffing winner for both client and talent service.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.

San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.