Referral Coordinator/Medical Assistant

Description

MAJOR FUNCTION: The Referral Coordinator is responsible for coordinating and managing patient referrals to internal and external providers to ensure timely access to care, continuity of services, and compliance with clinical, payer, and regulatory requirements. This role serves as a key liaison between patients, providers, insurance carriers, and healthcare partners.

ESSENTIAL RESPONSIBILITES: 

Referral Processing & Coordination

• Receive, review, and process provider referral orders for accuracy and completeness
• Coordinate internal and external referrals in accordance with clinical urgency and organizational guidelines
• Verify insurance requirements as needed
• Communicate referral details  to patients and receiving providers 

Patient Communication & Support

• Serve as a primary point of contact for patients regarding referral status and next steps
• Provide clear instructions, education, and follow-up to ensure referrals are completed
• Address patient questions and escalate concerns or delays appropriately
• Maintain a patient-centered, respectful, and confidential approach

Documentation & Compliance

• Ensure accurate and timely documentation of referrals and authorizations in the electronic health record (EHR)
• Maintain compliance with CMS, payer guidelines, HIPAA, and organizational policies
• Track referral outcomes, completion status, and denials

Coordination & Collaboration

• Collaborate with providers, nursing staff, care coordinators, and case management teams
• Communicate effectively with external specialists, facilities, and diagnostic services
• Escalate complex or urgent referrals to leadership when necessary

Quality & Performance

• Monitor referral turnaround times and follow established workflows
• Identify barriers to referral completion and participate in process improvement efforts
• Support audits and quality improvement initiatives related to referral management

Requirements

QUALIFICATIONS:

· Experience in ambulatory care, specialty clinics, or hospital-based referral departments

· Medical Assistant or healthcare administration background

· Familiarity with CPT/ICD-10 codes and payer authorization requirements

OTHER JOB DUTIES:

The above job description is not to be construed as a complete listing of the assignments that may be given to any employee, nor are such assignments restricted to those precisely listed in the description.

EOE

CompleteCare offers full-time and part-time employees a variety of generous benefits, including but not limited to:

· Comprehensive medical, dental, and vision insurance

· Paid time off (vacation, sick leave, and holidays)

· 401(k) retirement plan with employer matching

· Incentive program

· Life and disability insurance

· Employee Assistance Program (EAP)

· Continuing education and professional development opportunities

· Flexible Spending Accounts (FSA)

· Tuition reimbursement

· Reimbursement for licensure and certifications

· Reimbursement for CPR

· Discounted services 

· Employee recognition programs

· HRA/Ameriflex (covers most out of pocket expenses)

· Pension plan

· Cancer Policies

· Employee Paid Life insurance, 2 times annual salary up to $150K (CCHN paid benefit)

· AAA (discounted Rates

· BJ’s Wholesale Club (Discounted Rates) 

· Direct Deposit

· Child Care Reimbursement Program

· Intersite Travel