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.