Referral Representative - MA

IHA; Hartford (CT); On-site; USD 50,000 - 70,000; Full time

Benefits offered by this job

40 hours/week

Day shift

Benefits day 1

Competitive pay

Growth opportunities

Inclusive culture

Job summary

Trinity Health Of New England is seeking a Full-time Referrals Support Specialist to manage the Epic Referrals Workqueue, pre-authorization workflows, and patient registration updates. You will coordinate with clinical and customer service teams to ensure accurate referrals and payer requirements are met.

The role emphasizes strong organization, multitasking, and clear communication, with primary duties in referral processing and provider feedback.

Qualifications

• High Diploma or equivalent.
• Minimum of three (3) years’ experience in healthcare preferred.
• Experience in a medical office or billing department preferred.
• Medical terminology preferred.
• Knowledge of patient billing preferred.

Responsibilities

• Process and maintain the electronic Epic Referrals Workqueue prescreening for completeness of information, urgency, and other designated criteria.
• Completes pre-authorization workflows as required. Contact insurance companies to ensure prior approval requirements are met.
• Reviews and updates patient registration for membership eligibility and PCP selection.
• Enters referrals into the system per Trinity Health Of NE MGPS per protocols and provides feedback to ordering provider as needed.
• Informs maintenance analyst/resource library of payor, benefit specific information and provider contact information updates accordingly.
• Answers incoming phone calls to assist internal and external customers with referral-related questions, processes and problems.
• Other duties as assigned by Manager and Supervisor

Skills

Organizational skills

Multi-tasking

Communication skills

Follow-through

Education

High Diploma or equivalent

Tools

EPIC

Microsoft Word

Microsoft Excel

Microsoft PowerPoint

Microsoft Outlook

Job description

Employment Type

Full time

Shift

Day Shift

Description

Position Purpose: Working under the direction of the Referrals Supervisor, this position is responsible providing a variety of support services which are essential to the efficient operation of the organization’s referral process. Works closely with the clinical department staff as well customer service staff in the offices.

What You Will Do

• Process and maintain the electronic Epic Referrals Workqueue prescreening for completeness of information, urgency, and other designated criteria
• Completes pre-authorization workflows as required. Contact insurance companies to ensure prior approval requirements are met.
• Reviews and updates patient registration for membership eligibility and PCP selection.
• Enters referrals into the system per Trinity Health Of NE MGPS per protocols and provides feedback to ordering provider as needed.
• Informs maintenance analyst/ resource library of payor, benefit specific information and provider contact information updates accordingly
• Answers incoming phone calls as required to assist all internal and external customers by offering guidance and support for referral related questions, process and problems.
• Other duties as assigned by Manager and Supervisor

Minimum Qualifications

• High Diploma or equivalent
• Minimum of three (3) years’ experience in healthcare preferred. Experience within a medical office or billing department preferred. Medical terminology preferred. Knowledge of patient billing preferred.
• Proficiency with all Microsoft products (Word, Excel, Power Point and Outlook) required. EPIC experience preferred.
• Excellent organizational skills and ability to multi-task. Excellent oral and written communication skills. Ability to evaluate and manage multiple priorities and demonstrate follow-through.

Position Highlights And Benefits

• 40 hours, Day shift
• Great benefits effective day 1!
• Competitive pay!
• Growth Opportunities!
• Inclusive Culture!

We are a group of primary care providers, specialists and surgeons serving patients in Connecticut and western Massachusetts. Part of Trinity Health Of New England, we offer primary care, specialty care, surgery, urgent care, rehabilitation, and imaging and lab services for thousands of patients every year.

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.