Referral Coordinator

Department: Clinical Operations
Reports To: Practice Manager / Medical Director
FLSA Status: Non-Exempt
Schedule: Full-Time (High-Volume Clinical Environment)

Position Summary

The Referral Coordinator is responsible for managing and coordinating all patient referrals, prior authorizations, and related documentation to ensure timely access to specialty care and continuity of treatment. This role requires the ability to work under pressure in a fast-paced, high-volume primary care setting while maintaining accuracy, professionalism, and exceptional patient service.

The ideal candidate is highly organized, detail-oriented, and experienced in navigating insurance requirements, EMR systems, and frequent communication with providers, patients, and external offices.

Key ResponsibilitiesReferral & Authorization Management

• Coordinate and process referrals for specialty care, diagnostic testing, laboratory services, and imaging in a timely and accurate manner.

• Obtain and track prior authorizations from insurance carriers as required.

• Ensure all referrals and authorizations meet payer guidelines and documentation standards.

• Monitor referral status and follow up proactively to prevent delays in patient care.

Patient & Provider Communication

• Serve as a primary point of contact for patients regarding referral and authorization status.

• Communicate professionally with providers, specialists, insurance companies, and external medical offices.

• Address and resolve referral-related inquiries efficiently and empathetically in a high-call-volume environment.

Documentation & EMR Management

• Enter, update, and maintain referral and authorization information daily in eClinicalWorks (eCW) or equivalent EMR system.

• Ensure documentation is complete, accurate, and compliant with internal policies and payer requirements.

• Maintain organized tracking systems to manage workload and meet deadlines.

Workflow & Team Collaboration

• Manage multiple priorities simultaneously while maintaining accuracy under pressure.

• Collaborate closely with clinical staff, front office staff, and leadership to ensure seamless patient coordination.

• Follow direction from the Practice Manager and Medical Directors regarding workflow priorities and escalation processes.

Compliance & Professional Standards

• Maintain strict patient confidentiality and comply with HIPAA, organizational policies, and regulatory requirements.

• Maintain a clean, organized, and professional workspace at all times.

• Perform additional duties as assigned to support clinic operations.

QualificationsRequired

• High school diploma or equivalent.

• Minimum 1–2 years of experience in a medical office, referral coordination, or healthcare administrative role.

• Experience working in a high-volume primary care or specialty practice.

• Proficiency in eClinicalWorks (eCW) or similar electronic medical record (EMR) system.

• Strong understanding of insurance authorization and referral processes.

Preferred

• Formal medical office, healthcare administration, or billing training.

• Familiarity with Massachusetts insurance plans and referral requirements.

• Prior experience coordinating referrals for primary care, specialty care, and diagnostic services.

Skills & Competencies

• Ability to work efficiently under pressure in a fast-paced environment.

• Strong organizational, multitasking, and time-management skills.

• Excellent verbal and written communication skills.

• High attention to detail and accuracy.

• Professional demeanor and strong customer service orientation.

• Ability to work independently and collaboratively as part of a team.

Work Environment & Physical Demands

• Fast-paced, high-volume medical office setting.

• Prolonged periods of sitting, typing, and phone communication.

• Frequent interaction with patients, providers, and insurance representatives.