Referral Specialist
Core
Coordinate referral orders for specialty services and diagnostic testing within a primary care practice, ensuring payor authorization and closing patient care gaps.
Role type
Administrative Referral Coordinator
Builds
Continuation of treatment pathways for primary care patients
Domain
Healthcare / Primary Care Administration
Required skills
Medical terminology, Insurance authorization processes, Patient scheduling, HIPAA compliance, Payor regulations, Office software proficiency
Preferred skills
Managed care concepts, ICD-9 and CPT codes knowledge
Responsibilities
Schedule appointments for specialty services and diagnostic testing; Act as liaison between patients, providers, and staff; Verify coverage and obtain payor authorization; Track and manage referrals with follow-up at 30/60/90 day intervals; Collaborate with outside referral sources and community resources; Communicate with patients, physicians, staff, and third-party payers.