Referral Specialist

Job Location:

Pagosa Springs Medical Center - PAGOSA SPRINGS, CO 81147

Position Type:
Full Time

Education Level: High School

Salary Range: $18.00 - $22.38 Hourly

Job Shift: Day

Department:
Rural Health Clinic

Status:
Full-Time | 1.0 FTE (40 hours/week)

FLSA Status:
Non-Exempt

Reports To:

Manager:
Clinic

Location:

Pagosa Springs Medical Center – Pagosa Springs, Colorado (Remote/hybrid may be considered based on departmental needs.)

Help ensure patients receive timely access to specialty care by coordinating referrals, insurance authorizations, and communication between providers, patients, and specialty clinics.

Pagosa Springs Medical Center (PSMC) is seeking a detail-oriented and patient-focused Referral Specialist to join our Rural Health Clinic team.

• Process referrals from primary care and specialty providers using the electronic health record and referral management platform
• Verify patient demographics, insurance information, and referral requirements
• Compile and transmit clinical documentation, laboratory results, imaging, and other required records to receiving providers
• Monitor referral status from initiation through completion
• Follow up on outstanding referrals to ensure timely patient care
• Document all referral activity accurately within the electronic health record and referral management system

• Verify insurance coverage and referral requirements
• Obtain prior authorizations for services when required
• Monitor authorization expiration dates and obtain renewals as appropriate
• Ensure all required testing and documentation are completed prior to referral processing
• Maintain knowledge of referral requirements for commonly utilized specialty providers

• Communicate referral status with patients, providers, nursing staff, and specialty offices
• Respond to patient phone calls, voicemail messages, and patient portal communications in a timely manner
• Assist patients with questions regarding the referral process
• Communicate changes in referral requirements to clinic staff
• Coordinate care with the VA and other external organizations as appropriate

• Collaborate with providers and clinic leadership to ensure continuity of care
• Manage referral worklists and patient population lists
• Assist with patient outreach, scheduling, and coordination activities
• Monitor incoming referral faxes and electronic referrals
• Support quality initiatives and population health activities

• Utilize electronic fax systems and electronic health records efficiently
• Scan and upload documents into patient records
• Maintain accurate documentation using approved workflows and abbreviations
• Assist providers and clinic staff with referral-related questions and processes
• Participate in departmental training, quality improvement initiatives, and ongoing professional development

• High school diploma or equivalent required

• Minimum of two (2) years of experience in a clinical setting preferred
• Previous outpatient clinic or physician office experience preferred
• Previous clinical experience preferred but not required
• Previous electronic medical record (EMR) experience preferred

• Current AHA BLS (Heartsaver) certification required
• Strong computer proficiency, including Microsoft Office and electronic health records

• Excellent organizational and time management skills
• Strong attention to detail and accuracy
• Outstanding customer service and communication skills
• Ability to manage multiple priorities in a fast-paced environment
• Critical thinking and problem-solving abilities
• Ability to work independently while collaborating effectively with providers and clinical staff
• E…