Referral Specialist I
About The Position
At Father Joe’s Villages, access to healthcare is essential to supporting stability, recovery, and long-term well-being. The Healthcare Services team ensures individuals experiencing homelessness receive coordinated, timely medical care by removing administrative and system barriers that can delay treatment and services. The Role As a Referral Specialist, you will coordinate clinical referrals from initiation through completion, helping patients successfully access specialty care, diagnostic services, and community-based medical resources. You will serve as a liaison between providers, insurance payers, and patients to ensure referrals, authorizations, and follow-up care are completed accurately and efficiently. This role is ideal for a detail-oriented professional who enjoys coordinating care, navigating healthcare systems, and supporting equitable access to medical services for underserved populations.
Requirements
- High School Diploma, GED, or equivalent combination of education and relevant experience.
- Minimum of six (6) months to (1) year of experience in a healthcare, medical office, patient services, care coordination, or similar administrative healthcare environment.
- Experience working with electronic health records or scheduling systems
- Working knowledge of HIPAA privacy and confidentiality requirements.
- Basic computer proficiency and experience working with electronic health records or similar systems.
Nice To Haves
- Familiarity with medical terminology and healthcare documentation practices.
- Experience verifying insurance eligibility or supporting authorization and referral processes.
- Familiarity with CPT, ICD-10, or medical procedural coding concepts.
- Experience using electronic health records (EHR) and payer portals or willingness to learn new healthcare systems.
- Strong organizational skills with the ability to manage multiple referrals and competing priorities simultaneously.
- Ability to track workflows, follow up on outstanding items, and ensure timely completion of referral processes.
- Ability to communicate clearly and compassionately with patients, providers, and interdisciplinary teams.
- Professionalism and discretion when handling confidential patient information.
- Commitment to providing respectful, patient-centered service to individuals from diverse backgrounds.
Responsibilities
- Review electronic health records (EHR) to identify and process provider-submitted referrals within established timeframes.
- Coordinate referrals between clinicians, specialty providers, insurance payers, and patients to ensure continuity of care.
- Verify patient insurance eligibility and benefits through insurance portals and electronic systems.
- Prepare and submit prior authorization and pre-certification requests in accordance with payer and department requirements.
- Schedule specialty appointments, diagnostic services, Durable Medical Equipment (DME), or ancillary services as authorized by care providers.
- Monitor referral work queues and maintain accurate documentation to ensure referrals progress from initiation through completion.
- Follow up with providers to obtain consultation reports and upload results into the electronic health record.
- Provide patients with clear information regarding appointments, procedures, and preparation instructions.
- Assist patients with transportation coordination or connection to supportive resources when needed.
- Communicate referral outcomes with care teams to ensure the referral loop is closed.
- Cross-train and provide coverage for Patient Service Representative functions as needed.
- Complete required trainings and perform other related duties as assigned.
Benefits
- medical, dental, and vision coverage
- retirement plan options
- paid time off
- professional development opportunities
- wellness programs
- employee assistance resources to support work-life balance, health, and overall well-being
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
