Referral Specialist

Tyler Family Circle of•Tyler, TX

About The Position

Family Circle of Care is seeking a dependable and compassionate Referral Specialist to coordinate patient care by managing incoming and outgoing referrals, communicating with healthcare providers and patients, and ensuring referrals are processed accurately and promptly. The role supports patients in navigating healthcare needs and works collaboratively with providers, clinical staff, and other departments in a fast-paced healthcare environment. The Referral Specialist receives and processes referral requests, verifies insurance coverage and referral requirements, obtains authorizations when needed, and helps schedule specialty appointments and diagnostic services. The role tracks referrals through appointment completion, follows up on outstanding items, documents information in the Electronic Medical Record (EMR), and helps resolve referral delays or barriers. It also involves maintaining confidentiality, following HIPAA and other applicable compliance standards, participating in team activities, and assisting with additional operational responsibilities as needed. Family Circle of Care is a mission-driven Federally Qualified Health Center (FQHC) committed to improving the health and well-being of individuals and families throughout East Texas. The organization emphasizes teamwork, compassionate quality care, respect, and continuous improvement.

Requirements

High school diploma or equivalent.
Strong organizational skills and the ability to manage multiple priorities accurately in a fast-paced environment.
Excellent verbal and written communication skills.
Strong attention to detail and the ability to accurately document and maintain patient information.
Proficiency with computers and general office applications, including Microsoft Word and Excel.
Ability to work independently and collaborate effectively with providers, clinical staff, and other team members.
Commitment to maintaining patient confidentiality and providing excellent customer service.

Nice To Haves

Previous experience in a healthcare setting, medical office, or referral coordination role.
Knowledge of medical terminology, insurance verification, prior authorizations, and healthcare referral processes.
Experience coordinating specialty appointments and tracking patient referrals.
Experience with Electronic Medical Record (EMR) systems, preferably Epic.

Responsibilities

Receive, review, and process incoming and outgoing patient referrals from physicians' offices, hospitals, specialists, and other healthcare providers.
Communicate with patients, providers, and referral sources by phone, fax, and electronic systems to coordinate referral requests.
Verify patient insurance coverage, referral requirements, and eligibility for specialty services.
Obtain and process insurance referrals and prior authorizations as required by insurance plans and specialty providers.
Coordinate and assist with scheduling specialty appointments, diagnostic testing, and other referred healthcare services.
Track and monitor referrals through appointment completion, following up on outstanding referrals, missed appointments, and pending documentation.
Contact referring providers, hospital staff, or patients to obtain missing documentation, clarify information, and ensure referral requests are complete and accurate.
Document referral information, authorization details, appointment updates, and outcomes in the Electronic Medical Record (EMR) system.
Maintain organized and current referral records to support timely processing and continuity of patient care.
Identify potential delays or barriers in the referral process and collaborate with patients, providers, and clinical staff to resolve issues.
Collaborate with clinical staff, providers, and other departments to support communication and coordination of care.
Participate in team huddles and departmental activities to promote teamwork and improve patient care processes.
Provide customer service while maintaining professionalism, confidentiality, and compassion.
Follow organizational policies, HIPAA regulations, and applicable healthcare compliance standards to protect patient information.
Assist clinical and administrative staff with additional responsibilities as needed to support daily operations.