Patient Access & Referral Specialist

CommUnityCare; United States; Remote; USD 42,000 - 56,000; Full time

Job summary

CommUnityCare is seeking a Referral Coordinator to manage the patient referral process across clinics. You will coordinate referrals, schedule appointments, and ensure timely documentation in the EPIC system, while upholding accreditation standards and department SOPs.

The role emphasizes strong communication with patients, staff, and insurance carriers, plus adherence to regulatory guidelines and continuous quality improvement efforts within a community healthcare setting.

Qualifications

• Ability to build relationships with patients and staff while delivering accurate information.
• Strong attention to detail and accuracy in records and referrals.
• Proficient data entry and use of computer systems for scheduling and documentation.
• Excellent verbal and written communication and customer service skills.
• Knowledge of federal, state, and local insurance regulations and referral processes.

Responsibilities

• Coordinate patient referrals across departments and ensure timely processing.
• Schedule appointments according to clinic guidelines and capacity.
• Audit referral records and maintain up-to-date information in the system.
• Obtain referral authorizations from insurance carriers and relay decisions to patients and providers.
• Resolve pre-authorization, registration, or referral issues before appointments.
• Communicate with patients per protocol and keep referral resources current.
• Ensure referrals comply with SOPs and meet patient access needs.
• Document in EPIC and maintain accurate patient records.
• Attend team meetings and pursue continuing education and best practices.

Skills

Customer service

Attention to detail

Data entry

Verbal and written communication

Insurance regulations knowledge

Team collaboration

Education

High School Diploma or equivalent

Job description

CommUnityCare is seeking a Referral Coordinator to manage the patient referral process across clinics. You will coordinate referrals, schedule appointments, and ensure timely documentation in the EPIC system, while upholding accreditation standards and department SOPs.

The role emphasizes strong communication with patients, staff, and insurance carriers, plus adherence to regulatory guidelines and continuous quality improvement efforts within a community healthcare setting.