Referral Specialist

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

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Referral Specialist

Regular Full Time 259 Monroe Avenue, Rochester, NY 14607, Rochester, NY, US

2 days ago Requisition ID: 2069

Salary Range: $20.00 To $28.80 Hourly

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.