Referral Coordinator (Prior Authorization)

Job Summary:

We are seeking a highly organized and detail-oriented Healthcare Referral Coordinator to support the coordination of patient referrals to specialists and healthcare services. In this role, you will ensure accurate and timely processing of referrals, facilitate clear communication between patients, providers, and insurance companies, and help maintain the integrity of referral workflows. Your work will directly contribute to seamless patient care and a positive healthcare experience.

Key Responsibilities:

Referral Coordination:

• Process incoming and outgoing patient referrals in a timely and accurate manner.
• Ensure all required documentation is complete and submitted to appropriate specialists or healthcare service providers.
• Verify insurance eligibility and obtain prior authorizations as needed for referred services.
• Maintain accurate records in referral tracking systems and electronic health records (EHR).

Patient & Provider Communication:

• Communicate with patients to explain referral steps, answer questions, and provide updates as needed.
• Coordinate with primary care providers, specialists, and clinical teams to ensure continuity of care.
• Serve as a point of contact for referral-related inquiries from patients and healthcare staff.

Administrative Support & Compliance:

• Ensure all referral processes adhere to HIPAA and organizational confidentiality standards.
• Monitor referral queues and follow up on outstanding or incomplete referrals.
• Support continuous improvement efforts by identifying inefficiencies or common issues and escalating them to the lead or supervisor.

Qualifications:

• Education: High school diploma or equivalent required; associate degree or healthcare-related certification preferred.
• Experience: 1–2 years in a healthcare setting with experience in referral coordination, medical front office, or patient services preferred.
• Skills:
• Familiarity with medical terminology and healthcare systems.
• Strong organizational and time-management skills.
• Excellent interpersonal and communication skills.
• Proficiency with EHR systems, referral platforms, and scheduling software.
• Ability to work independently while following established procedures.