Patient Access & Referral Navigator

TRILLIUM HEALTH INC; City of Rochester (NY); On-site; USD 28,000 - 39,000; Full time

Job summary

TRILLIUM HEALTH INC in Rochester, NY is seeking a Referral Specialist to join our Clinic team. This position coordinates outgoing and off-site referrals, including imaging orders, and acts as the main interface between patients, providers, and community agencies.

Under supervision of the Supervisor, Referrals, you will verify eligibility, obtain prior authorizations, manage documentation in Epic EMR, and ensure timely scheduling.

Qualifications

• High School Diploma or equivalent required.
• Minimum 3 years in a medically based or human services setting.
• At least 2 years of EMR experience; Epic required.
• Knowledge of insurance carriers, prior authorizations, and community resources.
• Valid NYS Insurance Assister certificate preferred (or obtain within 6 months).

Responsibilities

• Navigate patient charts and clinical documentation in Epic EMR.
• Coordinate referrals and imaging orders via Epic and insurance portals.
• Verify eligibility and obtain prior authorizations/pre-certifications as needed.
• Route/fax medical documentation electronically and retrieve reports via RHIO.
• Track referral status and assist patients with scheduling appointments.
• Follow up on missed referral/imaging appointments.
• Communicate appointment details and preparation requirements to patients.
• Collaborate with Care Managers and other departments to resolve barriers.
• Ensure HIPAA compliance and maintain confidentiality of PHI.
• Perform other duties as assigned.

Skills

Epic EMR

Microsoft Office Suite

Medical terminology

HIPAA regulations

Customer service

Organization

Time management

Multitasking

Problem-solving

Written communication

Verbal communication

Bilingual preferred

Education

High School Diploma

3+ years in medical/human services setting

2+ years EMR experience (Epic)

Knowledge of insurance carriers and prior authorizations

NYS Insurance Assister certificate (or to obtain in 6 months)

Job description

TRILLIUM HEALTH INC in Rochester, NY is seeking a Referral Specialist to join our Clinic team. This position coordinates outgoing and off-site referrals, including imaging orders, and acts as the main interface between patients, providers, and community agencies.

Under supervision of the Supervisor, Referrals, you will verify eligibility, obtain prior authorizations, manage documentation in Epic EMR, and ensure timely scheduling.