Referral Coordinator

Description

JOB OVERVIEW: 

As a Referral Coordinator, you play a key role in helping patients gain access to specialty care by processing referrals, coordinating authorizations, and ensuring all required documentation is completed accurately and in a timely manner. You will work closely with providers, clinical staff, and outside offices to facilitate smooth transitions of care while providing excellent customer service to patients.

ESSENTIAL FUNCTIONS INCLUDE, BUT ARE NOT LIMITED TO: 

• Receive, review, and process incoming referrals from physicians, hospitals, and other healthcare providers.
• Verify patient insurance benefits and obtain prior authorizations as required for specialist visits, imaging, or      procedures.
• Ensure all referral documentation is complete and routed to the appropriate provider or department.
• Communicate with patients regarding referral status, required information, and scheduling next steps.
• Coordinate with clinical teams to ensure referrals and authorizations are completed before the patient’s      appointment.
• Follow up with insurance companies, outside offices, and patients to resolve delays or missing information.
• Maintain accurate logs, tracking systems, and documentation per TOI policies and payer requirements.
• Provide excellent customer service by actively listening, showing empathy, and offering solutions.
• Assist with office and clerical tasks as needed and support other staff within the department.

Requirements

QUALIFICATIONS/LICENSE: 

None

EDUCATION:

High School graduate or equivalent

EXPERIENCE:

• Prior healthcare, referrals, authorizations, or medical office experience preferred but not required.
• Previous customer service experience helpful.

SKILLS:

• Strong understanding or willingness to learn medical insurance processes, including authorization and referral requirements.
• Ability to read and interpret medical documentation and insurance guidelines.
• Excellent communication skills, both verbal and written.
• Strong organizational skills with the ability to manage high volumes of information.
• Basic computer skills with the ability to learn referral and practice management software.
• Ability to multitask and maintain accuracy in a fast-paced environment.

PHYSICAL REQUIREMENTS:

The physical demands describe here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.

• Specific vision requirements include the ability to see at close range, distance vision, peripheral vision, depth perception, and the ability to adjust focus.
• While performing the duties of this job, the employee is regularly required to talk and hear.
• Possess the ability to fulfill any office activities normally expected in an office setting, to include, but not limited to: remaining seated for periods of time to perform computer based work, participating in filing activity, lifting and carrying office supplies (paper reams, mail, etc.)
• Frequently required to stand, walk, sit, use hands to feel, and reach with hand and arms
• Occasionally lift and/or move up to 20-25 pounds.
• Fine hand manipulation (keyboarding).
• Travel may be required to existing or new TOI locations.