Job Description

Job Title:                       Referrals Clerk

Reports To:                        Medical Records and Referrals Supervisor

Job Summary:                     Processes and follows up referrals and some diagnostics, supplies clerical support to providers and support staff.


Essential Job Duties and Responsibilities:

The job duties and responsibilities listed below are representative of the knowledge, skill, and/or ability required.  Other duties that fall within the broad scope of this classification may be assigned.

  • Obtains Referral notes from specialists as required.
  • Acquires and documents referral information from physicians, patients, and insurance carriers.
  • Review’s referral paperwork to ensure that referrals are appropriate for the insurance carriers.
  • Ensures that prior authorizations are completed for referrals as required by the insurance carriers.
  • Follows-up to ensure that all required documents have been received by insurance carrier and referral is processed.
  • Processes diagnostics orders according to policies and procedures. 
  • Runs reports according to policies and procedures to follow up on open referrals and diagnostics until closing the loop, electronically filing and documenting steps in the process.
  • Working assigned weekends is required.


Minimum Qualifications - Education, Experience, Certificates & Licenses:

  • High School Diploma or GED.
  • Any combination of experience and/or education that provides the necessary skills required may be considered.
  • Valid Fingerprint Clearance Card may be required.


Preferred Qualifications:

  • Experience in medical records or referrals preferred.


Required Language Skills:

  • Ability to comprehend and compose instructions, correspondence, and communications in English in both oral and written format.


Physical Requirements:

  • Ability to occasionally exert enough force to move objects weighing up to 10 pounds.
  • Ability to continuously remain in a stationary position.
  • Ability to occasionally move about inside the workplace to access files, office machinery, etc.
  • Possesses hand-eye coordination and manual dexterity necessary to constantly operate computer, telephone, and other office machinery.
  • Possesses close visual acuity necessary to accurately record and view information on a computer monitor, handwritten and typed documents.
  • Ability to discern the nature of sounds at a normal spoken volume.


Other Required Knowledge, Skills, and Abilities:

  • Ability to add, subtract, multiply and divide, using whole numbers, common fractions, and decimals.
  • Ability to gather data in an organized fashion from varied sources.
  • Ability to take direction and perform assignments accordingly.
  • Knowledge of all aspects of insurance referral process.
  • Computer literacy required.
  • Understands covered services and contracted physicians enrolled with various insurance carriers.
  • Ability to provide excellent customer service by mail, telephone, and in-person.


Work Environment & Conditions:

  • Work environment is typical of an administrative office setting with no substantial exposure to adverse environmental conditions.

Important Notes

Will be responsible for Behavioral Health/Dental referrals