Patient Referral & Care Coordination Specialist

Mass Lung & Allergy, PC; Worcester (MA); On-site; USD 42,000 - 64,000; Full time

Job summary

Mass Lung & Allergy, PC in Worcester, MA seeks a Referral Coordinator to manage patient referrals, obtain authorizations, and coordinate communication among patients, providers, and payers. You will ensure timely continuation of care and maintain EMR documentation.

Responsibilities include scheduling with specialists and imaging centers, tracking referrals and denials, and adhering to HIPAA and payer guidelines while supporting clinical and administrative staff.

Qualifications

• High school diploma or equivalent; associate degree preferred.
• Minimum 12 years of healthcare, medical office, or referral coordination experience preferred.
• Knowledge of medical terminology, insurance plans, and prior authorization processes.
• Experience with EMR/EHR systems and Microsoft Office applications.
• Strong organizational, multitasking, and time management skills.
• Excellent verbal and written communication skills.

Responsibilities

• Receive, process, and track patient referrals from fax.
• Verify patient demographics, insurance coverage, and referral requirements.
• Obtain prior authorizations and insurance approvals as required.
• Schedule appointments with specialists, hospitals, imaging centers, and other healthcare providers.
• Communicate referral status and appointment details to patients and referring providers.
• Follow up on pending referrals, authorizations, and specialist reports.
• Maintain accurate referral documentation within the EMR system.
• Ensure referrals comply with payer guidelines and organizational policies.
• Resolve referral-related issues, denials, and authorization discrepancies.
• Request and obtain consultation notes, test results, and treatment recommendations from referred providers.
• Maintain confidentiality of patient information in accordance with HIPAA regulations.
• Collaborate with clinical, billing, and administrative staff to support patient care and workflow efficiency.

Skills

Verbal and written communication

Organization and time management

Teamwork and independence

Prior authorization knowledge

HIPAA and confidentiality awareness

Education

High school diploma or equivalent

Associate degree preferred

Tools

EMR/EHR systems

Microsoft Office

Job description

Mass Lung & Allergy, PC in Worcester, MA seeks a Referral Coordinator to manage patient referrals, obtain authorizations, and coordinate communication among patients, providers, and payers. You will ensure timely continuation of care and maintain EMR documentation.

Responsibilities include scheduling with specialists and imaging centers, tracking referrals and denials, and adhering to HIPAA and payer guidelines while supporting clinical and administrative staff.