REFERRAL COORDINATOR

NEW HOPE CAROLINAS INC•Rock Hill, SC

9d•Onsite

About The Position

The Referral Coordinator supports the Connection and Communications Department with the pre-admission process, focusing on compassionate communication and the collection, review, and distribution of all inquiries and referrals. This includes handling phone calls, website inquiries, and faxed and emailed documentation. The role involves developing and maintaining knowledge of the populations served, exclusionary criteria, active funding contracts, and other requirements relevant to the referral review process. The coordinator serves as a subject matter expert regarding services available and individuals who may or may not meet basic eligibility criteria. They are responsible for receiving, reviewing, organizing, and distributing clinical documentation, redirecting inappropriate referrals to appropriate external resources, and maintaining an accurate inquiry pipeline. Additionally, the role requires accurate data entry into the EHR and other systems, maintaining records in accordance with HIPAA and organizational requirements, and responding to inquiries promptly. The Referral Coordinator also communicates referral trends and unmet service needs, assists with satisfaction survey data collection, and may conduct initial reviews of referral packets. Maintaining confidentiality is paramount.

Requirements

Bachelor’s degree in Healthcare Administration, Health Services Administration, Healthcare Management, or a related field.
Experience working in an Electronic Health Record (EHR/EMR).
Must be at least 21 years of age.
Ability to pass required background checks, drug screening, and any state-mandated employment clearances.
Referral & Eligibility Management – Demonstrates knowledge of referral processes, eligibility requirements, exclusionary criteria, services offered, and funding sources to appropriately receive, review, document and route referrals.
EMR/EHR Proficiency– Accurately enters, updates, and maintains referral and client information in the EMR/EHR and other required systems in accordance with organizational standards and established workflows.
HIPAA, Confidentiality & Documentation Review – Demonstrates knowledge of HIPAA and confidentiality requirements while accurately reviewing, handling, storing, and transmitting referral documentation. Identifies missing or pertinent information and coordinates documentation with clinical staff for review.
Communication & Referral Coordination – Communicates professionally and compassionately with referral sources, clients, families, and internal departments while ensuring timely follow-up and appropriate referral coordination.
Attention to Detail & Accuracy – Maintains accurate referral records, inquiry dispositions, documentation, data entry, and follow-up activities while identifying discrepancies or missing information.

Nice To Haves

Experience with referral, intake, admission, and eligibility processes.
Knowledge of behavioral health services and admission criteria.
Knowledge of HIPAA, confidentiality, and PHI requirements.
Experience working in a healthcare/mental healthcare environment.

Responsibilities

Develop and maintain knowledge of the populations served, exclusionary criteria, active funding contracts, and other requirements relevant to the referral review process.
Serve as a subject matter expert regarding services available and individuals who may or may not meet basic eligibility criteria.
Receive, review, organize, and distribute clinical documentation to appropriate internal staff for review.
Redirect inappropriate referrals and inquiries to appropriate external resources when services cannot be provided.
Maintain an accurate inquiry pipeline, including referral status and disposition for all appropriate and inappropriate inquiries.
Accurately enter inquiries, calls, leads, and client information into the EHR and other required systems.
Maintain referral and client records in accordance with HIPAA, confidentiality, and organizational requirements.
Respond to referral and inquiry calls/emails within the same business day or within 24 hours.
Communicate referral trends, unmet service needs, and potential contract opportunities to the Connection and Communications Department.
Assist with the collection, tracking, and reporting of satisfaction survey data and other referral-related metrics for monthly and annual reports.
May conduct an initial review of referral packets to determine whether basic program criteria are met prior to clinical review.
Maintain confidentiality of all communications and documentation involving clients, referral sources, and external review agencies.
Perform other related duties as assigned by the Director of Referrals and Admissions.