Medical Referral Coordinator

The Medical Referral Coordinator is responsible for coordinating patient referrals to specialists, diagnostic services, and other healthcare providers. This role ensures referrals are processed accurately and efficiently, insurance requirements are addressed, appointments are scheduled, and patients receive timely information about their care.

Key Responsibilities

• Process and track patient referrals from providers and healthcare organizations.
• Verify insurance eligibility, benefits, and referral or authorization requirements.
• Obtain prior authorizations when required by insurance plans.
• Coordinate specialist, diagnostic, and ancillary-service appointments.
• Communicate with patients regarding referral status, appointments, and required documentation.
• Communicate with physicians' offices, specialists, insurance companies, and other healthcare facilities.
• Ensure referral documentation is complete and submitted accurately.
• Follow up on pending referrals, authorizations, and appointment outcomes.
• Maintain accurate records in electronic health records (EHR) and referral-management systems.
• Identify and resolve referral delays, missing information, and authorization issues.
• Protect patient confidentiality and comply with HIPAA and applicable healthcare regulations.
• Assist clinical and administrative staff with referral-related questions and tasks.
• Provide courteous, professional customer service to patients and healthcare partners.

Qualifications

• High school diploma or equivalent; healthcare-related education is a plus.
• Previous experience in healthcare administration, medical referrals, scheduling, insurance verification, or prior authorization preferred.
• Knowledge of medical terminology and healthcare workflows.
• Familiarity with insurance plans, referrals, and authorization processes.
• Experience with EHR systems and Microsoft Office or similar software.
• Strong attention to detail and organizational skills.
• Excellent verbal and written communication skills.
• Ability to manage multiple referrals and deadlines in a fast-paced environment.
• Ability to handle confidential patient information appropriately.
• MA Certificate preferred

Preferred Skills

• Prior experience in a medical office, clinic, hospital, or specialty practice.
• Experience working with referral or authorization portals.
• Strong problem-solving and follow-up skills.
• Bilingual or multilingual abilities, depending on patient population.

We have a small but busy medical primary care practice with two physicians and with wonderful co-workers who are always willing to help!