Referral Specialist
Core
Evaluates incoming medical referrals for accuracy and completeness, coordinates scheduling, and manages patient access in an ambulatory care setting.
Role type
Patient Access Specialist (Referral Specialist)
Builds
Patient appointment schedules and referral processing workflows
Domain
Healthcare / Ambulatory Care
Required skills
Medical referral evaluation, Insurance authorization verification, Patient scheduling, EHR documentation, Triage guidelines, Denial resolution
Preferred skills
Spanish language, Clinical coding/billing knowledge
Technologies
Electronic Health Record (EHR), Fax systems
Responsibilities
Review incoming referrals for accuracy and completeness; Verify patient demographics, insurance coverage, and prior authorizations; Schedule appointments according to triage guidelines; Communicate with referring providers and patients regarding access issues; Document all interactions in the EHR; Resolve referral denials and report trends to management.
Seniority
Entry-level to Mid-level, hands-on IC