Referral Specialist

Actalent; Santa Barbara (CA); On-site; USD 52,000 - 70,000; Full time

Job summary

Actalent is seeking a Referral Specialist in Santa Barbara to process and coordinate internal and external referrals to specialty providers, verify insurance coverage, obtain authorizations, and document all activities in the EHR/EMR system. The role requires clear communication with patients, providers, and specialty offices in a fast-paced environment.

The successful candidate will collaborate with clinical and administrative teams, manage high referral volumes, and ensure timely completion of

Qualifications

• Experience in referrals, authorizations, or a medical office setting.
• Strong understanding of insurance types (HMO, PPO, Medi-Cal) and related referral workflows.
• Experience with EMR/EHR systems to enter, track, and update referrals.

Responsibilities

• Process and coordinate internal and external referrals to specialty providers in a timely and accurate manner.
• Verify insurance coverage for patients and obtain prior authorizations as required.
• Submit referral requests to health plans or specialty offices and track status through completion.
• Ensure all supporting documentation is complete and attached to each referral.
• Communicate referral status clearly to patients, providers, and specialty offices.
• Maintain documentation in the EHR/EMR system for referrals and authorizations.
• Follow up on pending referrals to meet turnaround times and complete the process.
• Collaborate with front/back office staff and providers to support patient care coordination.
• Manage a high volume of referrals daily while staying organized and accurate.

Skills

Referral experience

Insurance knowledge

EMR/EHR proficiency

Team collaboration

Job description

Job Description
The Referral Specialist processes and coordinates internal and external referrals to specialty providers, ensuring timely and accurate completion of all referral-related activities. This role verifies insurance coverage, obtains prior authorizations, and maintains thorough documentation in the electronic health record system to support seamless patient care coordination. The Referral Specialist collaborates closely with clinical and administrative teams to manage high referral volumes in a fast-paced environment while providing clear communication to patients, providers, and specialty offices.

Job Title: Referral Specialist
Job Description
The Referral Specialist processes and coordinates internal and external referrals to specialty providers, ensuring timely and accurate completion of all referral-related activities. This role verifies insurance coverage, obtains prior authorizations, and maintains thorough documentation in the electronic health record system to support seamless patient care coordination. The Referral Specialist collaborates closely with clinical and administrative teams to manage high referral volumes in a fast-paced environment while providing clear communication to patients, providers, and specialty offices.
Responsibilities

• Process and coordinate internal and external referrals to specialty providers in a timely and accurate manner.
• Verify insurance coverage for patients and obtain prior authorizations as required by health plans and managed care organizations.
• Submit referral requests to health plans, independent practice associations (IPAs), or specialty offices and track status updates through completion.
• Ensure all supporting documentation, including chart notes, laboratory results, and imaging reports, is complete and attached to each referral.
• Communicate referral status and any updates clearly and professionally to patients, providers, and specialty offices.
• Maintain accurate and up-to-date documentation in the electronic health record (EHR) or electronic medical record (EMR) system for all referrals and authorizations.
• Follow up on pending referrals to meet established turnaround times and ensure completion of the referral process.
• Collaborate with front office staff, back office staff, and providers to support effective patient care coordination and resolve referral-related issues.
• Manage a high volume of referrals daily while maintaining organization, accuracy, and adherence to referral workflows.
• Apply medical terminology and knowledge of medical records to accurately interpret and process referral documentation.
  

Essential Skills

• Previous experience in referrals, authorizations, or a medical office setting preferred.
• Strong understanding of insurance types, including HMO, PPO, and Medi-Cal, and related referral workflows.
• Experience working with EMR/EHR systems to enter, track, and update referral information.
  

Additional Skills & Qualifications

• Experience in a healthcare or clinical environment supporting patient care coordination.
• Demonstrated ability to work collaboratively in a team-oriented environment.
• Comfort with adapting to changing priorities and workflows as needed.
• Motivation to grow within the organization and develop professionally.
  

Work Environment
This is a full-time position with a Monday through Friday schedule from 8:00 a.m. to 5:00 p.m. The role operates in a fast-paced healthcare setting