Clinic Referral Coordinator

The Referral Coordinator manages and tracks patient referrals to specialists, diagnostic services, and external providers to help ensure timely access to care. This role coordinates appointments, monitors referral status, and ensures required documentation and results are communicated to support continuity of care and prevent treatment delays.

Key responsibilities include:

• Coordinate and manage the referral process for assigned clinics in accordance with DRH policies and procedures.
• Help remove barriers to patient access by prioritizing and processing referrals based on patient needs, provider instructions, urgency, and appointment availability.
• Review incoming referrals for completeness and accuracy, including patient demographics, insurance information, diagnosis, clinical documentation, and provider orders.
• Obtain and verify information and documentation needed to process referrals and schedule patients appropriately.
• Coordinate insurance authorization and referral requirements, including payer-specific requirements and pre-service authorizations as needed.
• Communicate with referring providers, receiving providers, insurance companies, patients, and other departments to resolve referral issues and facilitate timely care.
• Monitor referral work queues and maintain accurate tracking of pending, scheduled, completed, and outstanding referrals.
• Follow up on referrals delayed by missing information, authorization requirements, inability to contact the patient, provider review, or other scheduling barriers.
• Prioritize urgent or time-sensitive referrals and escalate concerns to the appropriate provider or leader when necessary.
• Communicate referral-related updates, workflow changes, downtime, system issues, or other disruptions to routine operations.
• Maintain accurate documentation of referral activity, patient contacts, authorizations, scheduling attempts, and other required information in the electronic medical record and referral systems.
• Contact patients regarding referrals, appointments, required information, and insurance requirements while maintaining professionalism and confidentiality.
• Schedule and coordinate patient appointments with appropriate providers and departments based on referral information, clinical needs, provider instructions, and scheduling guidelines.
• Assist patients and referring offices with questions regarding referral status and provide appropriate information within the scope of the position.
• Identify referral backlogs, delays, or workflow concerns and communicate them to leadership in a timely manner.
• Work collaboratively with clinic staff, providers, nurses, scheduling teams, insurance representatives, and other departments to support timely access to care.
• Provide coverage for referral functions across clinics as needed.
• Perform front-desk or patient encounter representative duties as needed during staffing shortages or periods of increased volume.
• Travel to other DRH locations as needed.