Referral Specialist - Spring Hill Port Royal - Days Mon.-Fri. 7:30AM-4:00PM

Williamson Health; Franklin (TN); On-site; USD 42,000 - 52,000; Full time

Benefits offered by this job

PTO

Retirement Matching

FSA (Flexible Spending Accounts)

Identity Theft Protection

Legal Aid

Job summary

Williamson Health in Franklin, TN is seeking a Referral Specialist to coordinate all aspects of referrals for assigned clinics, ensuring timely processing and excellent patient service. This role requires collaboration with providers, staff, and insurers to maintain continuity of care.

Ideal candidates will have a high school diploma or GED and at least two years in a medical office setting, with experience in referrals, authorizations, and EMR systems preferred.

Qualifications

• High school diploma or GED required; associate degree preferred.
• Minimum of two years in a medical office or healthcare setting.
• Experience with referrals, prior authorizations, insurance verification, or care coordination preferred.
• Knowledge of medical terminology preferred.
• Strong customer service and communication skills.
• Experience using EMR systems preferred.

Responsibilities

• Coordinate all aspects of the referral process for assigned clinic(s).
• Ensure timely, accurate, and complete referral processing with excellent service.
• Serve as liaison throughout referral process to ensure continuity of care.
• Maintain compliance with organizational policies, payer requirements, and regulatory standards.
• Document referral activity accurately in the EMR.
• Collaborate with providers, nurses, and front office to facilitate care.

Skills

Customer service

Communication

EMR familiarity

Medical terminology

Education

High school diploma or GED

Associate degree or healthcare-related coursework preferred

Tools

EMR software

Multi-line telephone system

Microsoft Office

Job description

Referral Specialist - Spring Hill Port Royal - Days Mon.-Fri. 7:30AM-4:00PM

#26-795

About Us

Williamson Health is a regional healthcare system based in Williamson County, Tennessee, with more than 2,500 employees across more than 30 locations and more than 860 physicians and advanced care practitioners offering exceptional healthcare across 60-plus specialties and subspecialties close to home. The flagship facility, Williamson Medical Center, a 337-bed facility which recently opened its new Boyer-Bryan West Tower, offers extensive women's services, state-of-the-art cardiology services, advanced surgical technologies, an award-winning obstetrics and NICU, leading-edge orthopaedics, outpatient imaging services, and distinct comprehensive emergency and inpatient services for both adult and pediatric patients. Other Williamson Health service providers include the Bone and Joint Institute of Tennessee, The Turner-Dugas Breast Health Center, Monroe Carell Jr. Children's Hospital Vanderbilt at Williamson Medical Center, Williamson Health physician practices that are strategically located throughout the community, countywide Emergency Medical Services that include 18 rapid response units, Williamson Health Foundation, and multiple joint venture Vanderbilt Health and Williamson Medical Center Walk-In Clinics in Williamson County. Learn more about our many specialized services at WilliamsonHealth.org.

Williamson Health is a system where your talents will be valued and your skillset expanded. We are rooted in our promise to world-class, compassionate care for the residents of Williamson County and surrounding communities, taking exceptional pride in serving our community. We're committed to empowering our employees to work in innovative ways and reserve time and space for curiosity, laughter and creativity. We value and support the diversity and cultural differences among one another and are committed to upholding an inclusive environment that appreciates the uniqueness of all individuals. Our values are at the heart of everything we do: respect for every individual, the health and total well-being of all people, human compassion and integrity. These shape who we are as an organization and are essential for delivering the highest level of culturally competent care and treatment of every patient, family member, visitor, physician and employee.

Company Culture:
We are passionate about the care we offer and also our standards of performance which include compassion, respect, accountability and safety -- toward our patients and also toward our colleagues. We're looking for talented, caring, and mission-minded professionals who view their career in healthcare as more than just a paycheck, but as a true calling. We are proud of our unique culture that balances doing what we love, working alongside a supportive team, and maintaining a good quality of life - all while making a difference no matter your department or position.

Community Overview:
Franklin sits in the heart of Williamson County, which has the top-rated school system in the state, a plethora of parks and green spaces, fabulous restaurants, a rich traditional of hospitality, and of course, world-class healthcare. Various publications have showered Franklin with such accolades as one of the "Best Southern Towns," "Best Place to Live," "Top 10 Community for Job Growth," and "Top 50 Cities to Start a Small Business."

Job Description

Referral Specialist Job Description

Position Summary

The Referral Specialist is responsible for coordinating all aspects of the referral process for assigned clinic(s). This position ensures timely, accurate, and complete processing of referrals while maintaining excellent customer service for patients, providers, specialists, and insurance carriers. The Referral Specialist serves as the primary liaison throughout the referral process to ensure continuity of care, compliance with organizational policies, payer requirements, and regulatory standards.

Position Requirements

Education

• High school diploma or General Education Degree (GED) required.
• Associate degree or healthcare-related coursework preferred.

Experience

• Minimum of two (2) years of experience in a medical office or healthcare setting.
• Experience with referrals, prior authorizations, insurance verification, or care coordination preferred.
• Knowledge of medical terminology preferred.
• Strong customer service and communication skills.
• Experience using Electronic Medical Record (EMR) systems preferred.

Equipment & Technical Skills

Ability to operate:

• Computer and EMR software
• Multi-line telephone system
• Microsoft Office applications
• Standard office equipment

Quality & Compliance

• Maintains compliance with organizational policies, HIPAA regulations, payer requirements, and referral management standards.
• Documents all referral activity accurately and completely within the EMR.
• Protects confidential patient information in accordance with HIPAA and organizational policies.
• Maintains current knowledge of insurance requirements, referral guidelines, and EMR workflow changes.
• Assists in developing and improving referral workflows to increase efficiency and patient satisfaction.

Customer Service & Teamwork

• Demonstrates professionalism and excellent customer service in all patient, provider, and coworker interactions.
• Builds and maintains positive working relationships with specialty offices, insurance representatives, and internal departments.
• Participates in department meetings, education, and ongoing process improvement initiatives.
• Assists with orientation and training of new referral staff as requested.
• Performs other duties as assigned by the Practice Manager or Referral Coordinator.

The Referral Specialist is expected to:

• Be physically present in the assigned clinic during scheduled work hours.
• Maintain regular and reliable attendance and punctuality.
• Collaborate directly with providers, nurses, medical assistants, front office staff, and other departments to facilitate timely patient care.
• Respond promptly to patient, provider, and specialist inquiries while maintaining efficient referral workflows.
• Participate in daily operations, team meetings, training, and workflow improvement initiatives.
• Support clinic operations by assisting with referral-related needs that require an on-site presence.

Prior Authorization Responsibilities

• Processes prior authorizations for medications, diagnostic testing, procedures, and referrals as required by insurance carriers in a timely and accurate manner.
• Reviews insurance requirements and gathers all necessary clinical documentation to support medical necessity for prior authorization requests.
• Communicates with providers, clinical staff, pharmacies, insurance companies, and patients regarding the status of prior authorization requests and any additional information needed.
• Documents all prior authorization activities, approvals, denials, and follow-up actions accurately within the Electronic Medical Record (EMR).
• Monitors pending prior authorizations to ensure timely resolution, notifies providers of denials, and facilitates appeals or additional documentation when appropriate.
• Maintains current knowledge of payer-specific prior authorization requirements, formulary changes, and regulatory updates to ensure compliance and minimize delays in patient care.

Benefits Summary

Williamson Health is pleased to offer a comprehensive benefits program, that offers you choice and flexibility, so you can take charge of your physical, financial, and emotional well-being.

• PTO
• Retirement Matching
• FSA (Flexible Spending Accounts)
• Identity Theft Protection
• Legal Aid

Williamson Health is an equal-opportunity employer and a drug-free workplace.

WH is an equal employment opportunity employer. WH does not discriminate against any applicant or employee on the basis of race, color, sex, religion, national origin, age, disability, or any other consideration made unlawful by applicable federal, state, or local laws. WH also prohibits harassment of applicants and employees based on any of these protected categories.

It is also WH’s policy to comply with all applicable laws respecting consideration of unemployment status in making hiring decisions. The complies with the Americans with Disabilities Act ("ADA"), the ADA Amendments Act of 2008 ("ADAAA") and applicable state law and considers reasonable accommodation measures that may be necessary for qualified applicants/employees to perform the essential functions of the job. Hire may be contingent upon a post-offer medical examination, and to skill and agility tests, as appropriate for the position.