- Process referrals for specialty care, diagnostic testing, imaging, and other ancillary services in a timely manner.
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Obtain insurance authorizations and verify eligibility in accordance with payer requirements.
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Schedule appointments with specialists and communicate appointment details to patients.
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Coordinate follow-up care and ensure referral completion.
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Monitor referral work queues and maintain accurate documentation within the electronic health record (EHR).
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Communicate effectively with providers, clinical staff, specialists, hospitals, and insurance companies regarding referral status.
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Educate patients on referral processes and assist with navigating healthcare resources.
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Follow up on incomplete referrals and obtain consultation reports for the patient's medical record.
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Maintain confidentiality in accordance with HIPAA regulations.
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Assist with quality improvement initiatives related to referral management and patient access.
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Perform other duties as assigned.
- High school diploma or GED.
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Minimum of one (1) year of experience in a medical office, healthcare setting, or referral coordination.
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Knowledge of medical terminology.
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Experience working with electronic health records (EHR).
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Strong organizational, communication, and customer service skills.
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Ability to manage multiple priorities in a fast-paced environment.
- Associate degree in Healthcare Administration or related field.
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Certified Medical Assistant (CMA) credential preferred.
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Experience in a Federally Qualified Health Center (FQHC), primary care, or community health setting.
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Experience obtaining insurance authorizations and working with Medicaid, Medicare, and commercial insurance plans.
At Family Health Centers Inc., we are committed to providing high-quality, patient-centered healthcare to all members of our community, regardless of their ability to pay. We are seeking a compassionate, organized, and detail-oriented Referral Specialist to join our team.
The Referral Specialist plays a vital role in ensuring patients receive timely access to specialty care and diagnostic services. This position is responsible for coordinating referrals, obtaining prior authorizations, scheduling specialty appointments, and serving as a liaison between patients, providers, specialists, and insurance companies. The ideal candidate is committed to delivering exceptional customer service while supporting continuity of care for diverse patient populations.
