Referral Specialist

Trillium Health; City of Rochester (NY); On-site; USD 55,000 - 75,000; Full time

Job summary

Trillium Health is seeking a Referrals Specialist to join our mission-driven Clinic team. Under the direction of the Supervisor, Referrals, you will coordinate outgoing and off-site referrals, including imaging orders, and advocate to ensure patients are notified and scheduled for services.

You will monitor deferred referrals, manage documentation for quality compliance, and collaborate with Care Managers and other departments to remove barriers while preserving HIPAA confidentiality.

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 and manage patient charts and clinical documentation within Epic EMR.
• Coordinate referrals and imaging orders using 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 compliance

Customer service

Organizational skills

Time management

Multitasking

Communication skills

Bilingual preferred

Education

High School Diploma or equivalent

NYS Insurance Assister certificate preferred

Tools

Epic EMR

Microsoft Office Suite

Job description

Job Summary

Join us and be part of a mission-driven team that prioritizes innovation, collaboration, and continuous development. Under the direction of the Supervisor, Referrals, the Referrals Specialist serves as a primary interface between patients, providers, offices, medical facilities, and community agencies. This position coordinates outgoing and off-site referrals, including imaging orders, by assisting and advocating to ensure patients are appropriately notified and scheduled for services. The role also monitors and manages deferred referrals to ensure timely receipt of referral and order documentation for quality compliance.

Department

Clinic

Position Type: Full Time

FLSA: Non-exempt

Job Summary

Join us and be part of a mission-driven team that prioritizes innovation, collaboration, and continuous development. Under the direction of the Supervisor, Referrals, the Referrals Specialist serves as a primary interface between patients, providers, offices, medical facilities, and community agencies. This position coordinates outgoing and off-site referrals, including imaging orders, by assisting and advocating to ensure patients are appropriately notified and scheduled for services. The role also monitors and manages deferred referrals to ensure timely receipt of referral and order documentation for quality compliance.

Duties/Responsibilities

• Navigate and manage patient charts and clinical documentation within Epic EMR.
• Coordinate referrals and imaging orders using 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.

Required Skills/Abilities

• Proficiency in Epic EMR and Microsoft Office Suite.
• Strong knowledge of medical terminology and HIPAA regulations.
• Excellent customer service, organizational, and time management skills.
• Ability to multi-task and problem-solve effectively.
• Strong written and verbal communication skills; bilingual preferred.

Education and Experience

• 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).

Physical Requirements

While performing the duties of this job, the employee is regularly required to sit, stand, walk, and communicate effectively. Occasional bending, lifting up to 25 pounds, and other physical activities may be required. In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.