Referral Clerk

Principal Duties And Responsibilities:

• Coordinate and schedule all diagnostic testing and specialty consultations, both internal and external.
• Daily reports of referrals and diagnostic procedures are generated from the previous day to ensure prompt follow-up and resolution of pending items
• Ensure appropriate pre-authorization and referral procedures are followed according to payer guidelines.
• Serve as a liaison between patients, providers, and external specialists to ensure clear communication and timely appointments.
• Obtain medical records and consultation reports from external facilities where Betances has system access; attach and assign reports in the EHR as appropriate.
• Accurately document and maintain all referral information within the Electronic Health Record (EHR) and Practice Management system.
• Monitor and track the status of all referrals to ensure follow-through, receipt of consultation reports, and closure in the EHR.
• Communicate referral and appointment details to patients, providing instructions and answering questions regarding next steps.
• Follow up with providers or departments to obtain necessary documentation for pre-authorizations and referrals.
• Support internal departments with referral-related questions and ensure coordination of care between service lines.
• Generate and maintain referral tracking reports to support quality assurance and compliance initiatives.
• Participate in special projects, process improvement activities, and staff training as assigned.
• Perform other duties as directed by the supervisor or Executive Management Team.

Knowledge, Education, Skills And Abilities Required:

• High School Diploma or GED equivalent required;
• One (1) year + experience in a clinical or healthcare setting;
• Excellent customer service and telephone skills;
• Bilingual English/Spanish preferred;
• Excellent verbal and written communication skills, well developed organizational skills; reliable, and with great attention to detail.
• Knowledge of medical terminology required;
• Familiarity with components of medical records;
• Basic knowledge of health insurance procedures and regulations especially Medicaid, Medicare and managed care contracts required;
• Computer skills: Microsoft word, Office and Excel, Computerized Scheduling, mail merge;
• Able to handle multiple tasks and deadlines simultaneously;
• Knowledge of medical terminology, ICD-9 and CPT coding required;
• Ability to partner and work collaboratively with internal departments to meet organizational goals;
• Demonstrated proficiency in Microsoft Office programs; Electronic Health Record (ECW) preferred.

Summary:

The Referral Clerk is responsible for coordinating all internal and external referrals and diagnostic procedures to ensure timely access to specialty and ancillary services. This position serves as a liaison between patients, providers, and external partners to facilitate comprehensive and coordinated care. The Referral Clerk also ensures that all pre-authorization requirements are met, referral documentation is accurately maintained, and consultation reports are obtained and attached to the Electronic Health Record (EHR) to support continuity of care and compliance with organizational standards.