Clinical Referral Specialist

Balboa Nephrology • San Diego, CA

24d • $23 - $25 • Remote

About The Position

The Clinical Referral Specialist is responsible for coordinating outgoing clinical referrals from initiation through completion. This includes ensuring referrals are processed accurately, authorizations are obtained when required, appointments are scheduled, and documentation and results are appropriately recorded in the electronic medical record (Epic).

The specialist conducts patient outreach, communicates with specialty providers, and tracks referrals to confirm appointment scheduling, visit completion, and receipt of consult or procedure documentation when applicable. The role serves as a liaison between patients, physicians, clinic staff, and external specialty providers to support timely coordination of care.

This position reports to the Director of Central Operations with day-to-day supervision from the Clinical Referrals Supervisor.

Requirements

• Minimum 2 years of experience working in a clinical setting with front office responsibilities and patient-facing customer service.
• Minimum 1 year of experience using Epic or comparable electronic health record systems.
• Proficiency using EHR software applications and electronic referral workflows.
• Certified Medical Assistant
• Excellent verbal and written communication skills.
• Strong organizational and prioritization skills in a high-volume workflow environment.
• Ability to interpret, adapt, and apply operational guidelines and procedures.
• Ability to use sound judgment and escalate concerns appropriately.
• Ability to establish and maintain effective working relationships with patients, physicians, medical staff, and coworkers.
• Strong attention to detail and accuracy in documentation.
• Bilingual in English & Spanish

Nice To Haves

• 1 + years of experience processing outbound clinical referrals and obtaining insurance authorizations.
• Experience coordinating referrals across multiple specialty providers or healthcare systems.

Responsibilities

• Process outgoing clinical referrals from initiation through completion using Epic referral workflows.
• Prioritize referrals based on urgency and referral type in accordance with established Clinical Referral workflows.
• Answer inbound calls from patients, clinic staff, and specialty offices regarding referral status, appointment coordination, and documentation requests.
• Processing Clinical Referrals, including, but not limited to:
• Infusions
• Palliative care
• Podiatry
• Biopsies
• Hematology
• Oncology
• Kidney Transplant
• Dialysis Access
• Cardiology
• Nutrition Services
• Psychiatry
• Urology
• Vascular Surgery Access (non-dialysis)
• Imaging/Radiology
• Verify insurance coverage and determine whether prior authorization is required.
• Submit prior authorization requests with required clinical documentation and track approval status.
• Communicate appointment instructions to patients and coordinate referral scheduling when applicable.
• Conduct patient outreach through phone calls, voicemail, and secure messaging when patients cannot be reached.
• Document all outreach attempts, referral updates, and patient communications accurately in Epic using standardized documentation templates.
• Upload referral packets, authorization approvals, consult notes, and supporting documentation into Epic Media Manager.
• Transmit referral documentation and authorizations to specialty providers via electronic fax or portal submission when applicable.
• Monitor referral work queues and manage referral status updates to ensure timely progression through the referral workflow.
• Follow up with patients and specialty providers to confirm appointment scheduling, visit completion, and receipt of consultation notes or procedure documentation when required.
• Apply escalation protocols when patients cannot be reached or when clinical urgency requires provider notification.
• Close referrals appropriately in Epic once workflow steps and documentation requirements are complete.
• Monitor referral-related fax queues and respond to inbound documentation as needed.
• Provide ongoing coordination and communication with physicians, medical assistants, clinic teams, dialysis providers, and external specialty partners to support timely referral processing and continuity of patient care.
• Support Central Operations activities as needed, which may include assisting the New Patient Referrals and Dialysis Transition teams during high-volume periods.
• Perform other duties as assigned.

Benefits

• Comprehensive benefits package that includes medical, dental & vision on the 1st of the month 30 days after hire.
• Employer contribution of up to 7.5% of annual pay for your 401K.
• Generous paid time off plus 8 paid holidays, a birthday float day off and a mental health day!
• Company paid life insurance.
• Join a fast-growing field - employment of medical and health services managers is projected to grow 32 percent from 2020 to 2030, much faster than the average for all occupations.
• Voted 4 years in a row as a Top Workplace of San Diego 2020-2024!

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed