Referral Specialist

PACKARD HEALTH INC; United States; Hybrid; USD 42,000 - 66,000; Full time

Job summary

PACKARD HEALTH INC. seeks a Referral Coordinator to support care coordination and streamline referral workflows in a community health setting.

On-site presence is required; hybrid work with routine on-site engagement twice weekly ensures smooth scheduling, patient communication, and documentation in the EHR.

The role emphasizes HIPAA-compliant documentation, collaboration with providers, and helping patients navigate coverage and resources.

Qualifications

• High school diploma or equivalent required.
• Associate degree in healthcare administration or related field preferred.
• Minimum 2 years of experience in referral coordination, scheduling, or prior authorizations.
• Experience in an FQHC, community health center, or primary care setting strongly preferred.
• Knowledge of insurance plans, authorization requirements, and referral workflows.
• Proficiency in Epic strongly preferred.

Responsibilities

• Receive, review, and process provider-initiated referrals to specialty and ancillary services.
• Verify insurance eligibility and determine prior authorization requirements.
• Prepare and submit referral documentation to payers or external providers.
• Communicate with specialists, imaging centers, and hospitals to schedule appointments.
• Follow up on pending referrals to ensure timely completion.
• Document referral activity in the EHR with accuracy and completeness.
• Notify patients of referral status, authorization approvals, and appointment details.
• Assist patients regarding the referral process, coverage, and resources.
• Collaborate with care teams to support continuity of care.
• Maintain HIPAA-compliant documentation and participate in quality initiatives.

Skills

Referral coordination

Communication

Prior authorizations

EHR documentation

Attention to detail

Education

High school diploma or equivalent

Associate degree in healthcare administration

Tools

Epic

Job description

Essential FunctionsMust be on site twice a week and reside locally.Receive, review, and process provider-initiated referrals to specialty and ancillary services.Verify insurance eligibility and determine prior authorization requirements.Prepare and submit complete referral documentation to payers or external providers.Communicate with specialists, imaging centers, and hospitals to schedule and confirm patient appointments.Follow up on pending or incomplete referrals to ensure timely completion.Document all referral activity in the electronic health record (EHR), ensuring accuracy and completeness.Notify patients of referral status, authorization approvals, and appointment details.Provide assistance and education to patients regarding the referral process, coverage limitations, or community resources.Help identify and resolve barriers to care, such as transportation or communication challenges.Collaborate closely with medical providers, care managers, and front desk staff to support continuity of care.Maintain effective communication with external specialists and ensure clinical information is exchanged as needed.Track and close referral loops, ensuring that results and consult notes are received and routed to the ordering provider.Adhere to payer, FQHC, and HIPAA regulations regarding documentation and patient confidentiality.Support quality improvement efforts related to referral completion and care coordination.Participate in training, team meetings, and workflow improvement initiatives.Maintain exemplary customer service.Education and ExperienceHigh school diploma or equivalent required; associate degree in healthcare administration or related field preferred.Minimum 2 years of experience in a medical office or health system performing referral coordination, scheduling, or prior authorizations.Experience in an FQHC, community health center, or primary care setting strongly preferred.Knowledge of insurance plans, authorization requirements, and referral workflows.Proficiency in Epic strongly preferred.