Referral Specialist

JOB SUMMARY

The Medical Assistant, Specialty Care primarily manages patient referrals, ensuring smooth coordination between patients, healthcare providers, and insurers. Key responsibilities include processing referrals, verifying documentation, tracking outcomes, maintaining accurate health records, and connecting patients with appropriate resources. When coverage is needed, this role also supports clinical operations by performing Medical Assistant duties such as taking vital signs, preparing exam rooms, assisting with patient visits, scheduling appointments, managing records, coordinating follow-up care, and supporting patient check-out—helping maintain efficient workflow and quality patient care.

ESSENTIAL DUTIES & RESPONSIBILITIES
Referral Responsibilities:

• Efficiently coordinate all patients’ referrals at the request of providers, ensuring timely and accurate processing.
• Serve as primary point of contact for patients regarding their referral status, providing updates and answering questions as needed.
• Obtain patient medical records, test results, and insurance information to support referral requests.
• Track and follow up on all patient referrals to ensure completion and receipt of specialty care.
• Collaborate with primary care providers, specialty care providers, and insurance companies to facilitate smooth referral process.
• Appropriately determines and validates patient eligibility, validates patient demographic information, and gathers required documentation
• Prepare authorizations and follow-up on pending referrals
• Notify patients of scheduled appointments, provide instructions, and accurately track and record referral updates and reports in the referral system and electronic health record (EHR).
• Submit and track prior authorizations with insurance companies, following up until determinations are received.
• Maintain strict patient confidentiality in accordance with HIPAA and organizational privacy policies.
• Identify and escalate urgent, complex, or delayed referrals to clinical staff or supervisors as appropriate.
• Maintain accurate and organized referral records for audits, reporting, and quality assurance purposes.
• Efficiently notify the patient of said appointment to give instructions, and proficiently track and records reports in the referral systems and electronic health record as they are received.
• Fulfill other duties and responsibilities as needed and assigned.

Medical Assistant Responsibilities:

• Perform routine blood pressure, temperature, height, and weight for all patients prior to provider visit or as requested by medical provider.   
• Place patients and patient paperwork into clean, prepared exam room when scheduled for a provider visit.   
• Assist healthcare providers during patient visits by accompanying patients to examination rooms, providing comfort and support, and assisting with procedures as directed. 
• Collaborate with healthcare providers in follow-up appointments. 
• Coordinate patient appointments, ensuring accurate scheduling and timely reminders. 
• Assist healthcare providers in managing patient orders, including prescription refills, diagnostic tests, and specialist referrals, ensuring adherence to established protocols. 
• Provide patients with relevant educational materials and information regarding their health conditions, treatment plans, medications, and lifestyle modifications as directed by healthcare providers. 
• Maintain accurate and up-to-date patient records, including entering data into electronic health record (EHR) system.   
• Communicate with patients regarding test and laboratory results via phone or mail. 
• Prepare Doctor's letters and memos.   
• Facilitate the check-out process by verifying patient information, collecting payments, and scheduling follow-up appointments. 
• Maintain inventory of medical supplies and equipment and coordinate replenishment as needed. 

MINIMUM REQUIREMENTS

• Bi-lingual in Spanish or Korean preferred 
• Ability to work in a fast-paced environment, and to multi-task 
• Current BLS  
• Excellent interpersonal, verbal, written communication skills 
• Outstanding computer skills and knowledge of electronic health record
• Strong Microsoft skills, including Outlook, Word, Excel, and SharePoint
• Ability to recognize and maintain confidentiality of information as appropriate 
• Willing to travel to other sites if needed.

Pay: $23.00 - $26.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Flexible spending account
• Health insurance
• Paid time off

Experience:

• Medical Assistant: 1 year (Preferred)
• Medical Referrals: 1 year (Preferred)

Language:

• Spanish (Preferred)

Work Location: In person