Referral Coordinator

Position Summary: The Referral Coordinator plays a critical role in supporting patient-centered care by managing and coordinating medical referrals for both adult and pediatric patients. This position serves as a liaison between patients, providers, specialists, and community resources to ensure timely access to specialty care and continuity of services.
As part of a multidisciplinary team within a Federally Qualified Health Center (FQHC), the Referral Coordinator helps navigate patients through the healthcare system, reduces barriers to care, and ensures all referral-related documentation is accurate, complete, and compliant with regulatory standards.

Essential Job Responsibilities

Referral Coordination & Follow-Up
Manage, track, and maintain all outgoing referrals from primary care providers.
Monitor referral status and ensure timely completion through EHR tracking, fax correspondence, and communication with specialist offices.
Follow up to confirm appointment completion and obtain consult notes, test results, and recommendations.
Upload documentation into the EHR and notify providers of critical results or follow-up needs.
Close referrals once all required documentation has been received and reviewed.

Patient Support & Navigation
Educate patients on referral processes, expectations, and next steps.
Serve as a point of contact for patients and families regarding referral status and questions.
Assist patients in overcoming barriers to care, including transportation, financial concerns, or language needs.
Act as a patient advocate when working with insurance providers or external organizations.

Insurance & Authorization
Verify insurance requirements and obtain prior authorizations as needed.
Communicate with insurance companies and review organizations to ensure approvals are secured.
Provide necessary clinical documentation to support authorization requests.

Documentation & Compliance
Maintain accurate and up-to-date referral records, communication logs, and patient information in the EHR.
Ensure patient charts reflect specialist visits, hospitalizations, and external care coordination.
Monitor incoming fax queues and respond to documentation requests from specialist offices.
Ensure all activities comply with HIPAA, FQHC, HRSA, and quality improvement standards.

Collaboration & Community Coordination
Work closely with providers, medical assistants, front office staff, care managers, and leadership.
Build and maintain relationships with specialist offices and community partners.
Identify and utilize community resources to support patient care needs.

Qualifications and Work Environment
High school diploma or equivalent required.
Minimum of 1 year experience in healthcare, referral coordination, insurance verification, or a medical office setting. Experience in an FQHC or community health setting preferred.
Knowledge of referral processes for both adult and pediatric populations preferred.
Bilingual (Spanish or other languages) strongly preferred.
Proficiency in Electronic Health Record (EHR) systems (e.g., eClinicalWorks) and general computer skills required.
Strong organizational skills with attention to detail and the ability to manage competing priorities.
Excellent written, verbal, and interpersonal communication skills.
Demonstrated professionalism with the ability to maintain strict confidentiality in accordance with HIPAA.
Ability to problem-solve and navigate complex systems to support patient care.
Office-based within a clinical setting with frequent interaction with patients, providers, and external partners.
Must be comfortable working in a fast-paced, team-oriented environment serving diverse and underserved populations.
Ability to sit or stand for extended periods and perform prolonged computer work.