Under the supervision of the Clinic Manager, the Referral Specialist supports the medical providers at the clinic by coordinating any additional care the patient may need inside and outside of our facilities. This position is responsible for completing referrals of patients to specialists to ensure follow-up care is provided and is responsible for obtaining prior authorizations needed for testing or services. The Referral Specialist supports patient-centered care by ensuring coordination with the primary care provider, specialist(s) and the patient to ensure optimal patient outcomes.

Essential Duties and Responsibilities:

1. Expedites referrals entered into electronic health records system (EHR) by providers according to SBNC Policies and Procedures and in a timely manner.
2. Assembles information concerning patient’s clinical background and referral needs to provide to the specialist offices.
3. Strives to expedite referrals for patients at the date of service.
4. Schedules referral appointments and informs patients of appointment details such as location, date and time, etc.
5. Tracks all referrals for completion, receipt of specialists’ records in EHR with the support of the medical assistant staff.
6. Assists with scanning of paper consultation, imaging, etc. reports and uploads into EHR.
7. Protects patients’ confidentiality and right to privacy.
8. Provides appropriate referral authorizations to specialist offices.
9. Obtains prior authorizations for diagnostic services and procedures.
10. Provides back up support to other positions in the organization such as the Patient Access Navigator and Medical Assistant.
11. Verifies patient eligibility, address, and phone number with each visit.
12. Keeps work area clean and orderly.
13. Checks email upon arrival every morning and throughout the day to keep himself/herself informed of day to day functions and important communications with administration and clinic staff.
14. May need to cover at other sites if needed.

Other duties and responsibilities

1. Demonstrates understanding of and observe all SBNC policies, procedures, rules and regulations.
2. Demonstrates successful work-related behaviors.

1. Attends all required SBNC meetings and trainings.
2. Interacts with patients, physicians, staff, vendors, and visitors in a positive manner that reflects the SBNC mission and philosophy.
3. The above statements are intended to describe the general nature and level of work being performed by most people assigned to this job. They are not intended to be an exhaustive list of all responsibilities, duties, and requirements. The omission of specific statements of duties does not exclude them from the position if the work is similar, related or it is a logical assignment to the position. The employee is expected to perform other duties necessary for the effective operation of the department.

1. The above statements are intended to describe the general nature and level of work being performed by most people assigned to this job. They are not intended to be an exhaustive list of all responsibilities, duties, and requirements. The omission of specific statements of duties does not exclude them from the position if the work is similar, related or it is a logical assignment to the position. The employee is expected to perform other duties necessary for the effective operation of the department.

Qualifications and Education Requirements