Clinical Support Specialist - Referrals

Affinity Health Center; Rock Hill (SC); On-site; USD 23,000 - 29,000; Full time

Benefits offered by this job

Paid-time-off

Fully funded Health Insurance

Continuing education time and funding

Group Health / Life / Dental / Vision

403B Retirement Plan with 3% match

12 Paid Holidays

Job summary

Affinity Health Center in Rock Hill, SC is seeking a Clinical Support Specialist to ensure seamless referral coordination and closed-loop tracking. You will receive, triage, and process referrals, schedule specialty visits, and ensure complete clinical information is provided to specialists.

You will review processes with patients, address barriers, monitor referrals to completion, and help move abnormal screening results to timely follow-up, while maintaining privacy and accuracy in the EHR.

Qualifications

• High school diploma or GED; [1-3] years in healthcare including referral coordination, patient navigation, medical assisting, scheduling, prior authorization, or patient access; EHR proficiency and discretion with protected health information.
• Experience with referrals and prior authorization and knowledge of Medicaid/Medicare, managed care, and sliding fee resources.
• Strong organizational and communication skills; ability to manage high-volume referral queues and interact with diverse populations.

Responsibilities

• Receive, triage, and process all patient referrals, prioritizing by clinical urgency.
• Schedule specialty visits, radiology, diagnostics, and procedures, accounting for insurance, network, transportation, and language needs.
• Send complete clinical information to the specialist in advance.
• Review the referral process with patients, confirm understanding, and address barriers; deliver reminders and reschedule no-shows.
• Track every open referral to completion with an active referral log and follow-up until documentation is in hand.
• Route completed reports to the referring provider for review and document closure in the EHR.

Skills

Exceptional attention to detail

Organization and follow-through

Strong work ethic and ownership

Time management

Clear empathetic patient communication

Technical knowledge

Resourcefulness and adaptability

Education

High school diploma or GED

EHR proficiency and discretion with PHI

Reliable transportation

Experience with referrals and prior authorization

Job description

About the Organization

Affinity Health Center's mission is to serve the healthcare needs of our community by providing access to high-quality, comprehensive care with compassion, dignity and respect.

Affinity Health Center's vision is for a healthy and vibrant community where all people have access to exceptional and comprehensive healthcare.

Description

A referral should never be a dead end. It's a promise that a patient who needs a specialist, a mammogram, or a colonoscopy will actually get there - and that the results will make it back to their provider in time to matter. The Clinical Support Specialist is the person who keeps that promise. If you take pride in the fact that nothing falls through the cracks on your watch, you will thrive here.

What You'll Do

Referral Coordination & Closed-Loop Tracking

• Receive, triage, and process all patient referrals, prioritizing by clinical urgency.
• Schedule specialty visits, radiology, diagnostics, and procedures, accounting for insurance, network, transportation, and language needs.
• Send complete clinical information - notes, labs, imaging, and the referral question - to the specialist in advance.
• Review the referral process with patients, confirm understanding, and address barriers; deliver reminders and reschedule no-shows.
• Track every open referral to completion: maintain an active referral log, monitor reports not yet received, and conduct persistent documented follow-up until documentation is in hand.
• Route completed reports to the referring provider for review and document closure in the EHR.

Cancer Screening Partnerships

• Support cervical, breast, and colorectal screening partnerships.
• Ensure abnormal results move rapidly to diagnostic follow-up, with no abnormal result untracked.

Prior-Authorizations

• Initiate, submit, and track prior authorizations for imaging, procedures, and occasionally medications.
• Compile documentation to meet payer medical necessity criteria; verify eligibility and benefits.
• Manage denials - coordinate peer-to-peer reviews, support appeals, and identify alternatives including patient assistance and sliding fee resources.

Skills Needed to Succeed

• Exceptional attention to detail - accuracy in clinical, insurance, and scheduling data is non-negotiable.
• Organization and follow-through - manage a high-volume aging referral queue without losing a single case.
• Strong work ethic and ownership - persistence in chasing a report that's three weeks late; initiative to solve problems unprompted.
• Time management - sort urgent from routine and handle both in the same day.
• Clear, empathetic patient communication across varied health literacy and cultural backgrounds; professional communication with specialists and payers.
• Technical knowledge - medical terminology, cancer screening modalities and result terminology, Medicaid/Medicare/managed care and sliding fee, prior authorization and appeals workflows.
• Resourcefulness and adaptability - find the appointment, the authorization, or the funding source when the obvious path is blocked.

Qualifications

Required

• High school diploma or GED.
• [1-3] years in healthcare - referral coordination, patient navigation, medical assisting, scheduling, prior authorization, or patient access.
• EHR proficiency and demonstrated discretion with protected health information.
• Reliable transportation required
• Experience with referrals and prior authorization

Preferred

• Bilingual English/Spanish strongly preferred - fluency sufficient for patient education.
• Experience in a medical office preferred
• Familiarity with medical terminology preferred
• Certification (CMA, CCMA, Patient Navigator, Certified Referral Specialist) or degree in health administration, public health, or related field.

Pay Range

$17.00- $21.00 per hour (based on experience and qualifications)

Benefits

• Paid-time-off
• Fully funded Health Insurance
• Continuing education time and funding
• Group Health /Life/Dental/Vision/Disability
• 403B Retirement Plan with 3% match
• 12 Paid Holidays

Position Requirements

EOE Statement Disclaimer: This job description is a summary of the primary duties and responsibilities of the job and position. It is not intended to be a comprehensive or all-inclusive listing of duties and responsibilities. Contents are subject to change at management's discretion.

Condition of Employment: Per policy, vaccination against the Seasonal Flu is an Employee Health Standard and Condition of Employment for all new employees of Affinity Health Center. New employees must have initiated the vaccination process prior to their start date or initiate vaccination upon onboarding.

EEO: It is the policy of Affinity Health Center to ensure equal employment opportunity without discrimination because of race, religion, color, sexual orientation, political affiliation, physical disability, national origin, sex, gender identity, gender expression, military status, age, pregnancy, or any pregnancy-related medical conditions, including, but not limited to, lactation, except when the basis is a bona fide occupational qualification.

ADA: It is Affinity Health Center's (AHC) policy to comply with all relevant and applicable provisions of the Americans with Disabilities Act (ADA) and related state and local laws. Affinity Health Center will not discriminate against any qualified employee or job applicant with respect to any terms, privileges, or conditions of employment because of physical or mental disability. AHC will make reasonable accommodations for employees or applicants with disabilities, provided that the individual is otherwise qualified to safely perform the essential functions of the job, with or without accommodation, and provided that any accommodations made do not impose an undue hardship. Individuals who feels that an accommodation is necessary to be able to perform the essential functions of the job should contact Human Resources.

This position is currently accepting applications.

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