Referral Coordinator - Ophthalmology Clinic

Overview

Employer paid benefits - Medical, Dental, and Vision

Hourly Rate:
Min: $19.85 Max: $30.40

The Referral Coordinator is a vital member of the care coordination team, responsible for managing all aspects of the referral process to ensure patients receive timely access to specialty care, diagnostic testing, procedures, or medications. This role works collaboratively with providers, medical assistants, front office staff, and business office personnel to ensure prior authorizations are obtained, insurance requirements are met, and complete and accurate documentation is maintained within the electronic medical record (EMR).

The Referral Coordinator facilitates the flow of information between internal teams and external specialists, ensuring that all referral appointments are properly scheduled, authorized, and communicated to patients. Responsibilities also include verifying insurance eligibility, preparing and scanning records, managing phone and EMR messages, and maintaining accurate and timely updates in the patient chart.

This position plays a critical role in delivering seamless patient experience and supporting overall clinic operations through efficient referral coordination and communication. Additional tasks may be assigned by the Practice Manager as needed.

• Referral Management: Coordinates all inbound and outbound referrals by reviewing provider orders, initiating referral requests, and ensuring necessary documentation (chart notes, imaging, labs, etc.) is submitted accurately to the receiving specialist or facility.
• Scheduling & Follow-Up: Correctly schedules, cancels, or reschedules referral-related appointments according to practice guidelines, either by phone or in person. Tracks the status of referrals to completion, including follow-up appointments and specialist feedback.
• Insurance Verification & Prior Authorizations: Verifies patient insurance eligibility and coverage for referred services. Obtains prior authorizations when required for procedures, specialty visits, diagnostics, or medications, and communicates effectively with insurance payors.
• Electronic Medical Record (EMR) Management: Accurately documents all referral activity and communication in Epic (or other EMR), ensuring documentation is current, complete, and accessible for care teams. Scans referral-related documents and updates records as needed.
• Patient Communication: Informs patients of referral status, appointment details, and any required steps or documentation. Acts as a resource for patients regarding specialist locations, insurance requirements, and next steps in the care process.
• Message Handling: Answers incoming calls and responds to in-person inquiries with professionalism. Takes clear and complete messages following clinic protocols and ensures timely delivery to the appropriate staff member or provider.
• Chart Preparation & Support (Clinic Dependent): In some clinics, Referral Coordinators may support chart prep by ensuring medical records and referral documentation are available in the chart at the time of appointment, including verifying forms and insurance status. This may vary depending on clinic size and workflow structure.
• No-Show Documentation: Documents appointment no-shows in Epic if front desk staff are unavailable, following clinic procedures for follow-up and continuity of care.
• Team
  
  Collaboration:
  
  Works closely with providers, nursing staff, front office, and the business office to support seamless care coordination. Provides coverage or assistance to the front office when needed and promotes a collaborative team environment.
• Customer Service & Confidentiality: Maintains a patient-first approach by delivering excellent customer service while adhering to AIDET communication principles and HIPAA privacy standards.
• Work Schedule Flexibility: Must be flexible and available to work various shifts, including extended evening hours or weekends, based on clinical needs. Adjustments to hours or responsibilities may be required as workload or patient volume fluctuates.
• Other Duties as Assigned: Performs additional tasks or projects as directed by the Practice Manager or clinic…