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Referral Specialist

726f2022 6a92 400a 8c35 Ffee81e324bd 19000101 000001 · Kalamazoo, MI, US, Kalamazoo, MI · Active · ADP Workforce Now Recruiting

Job facts

FieldValue
Company726f2022 6a92 400a 8c35 Ffee81e324bd 19000101 000001
TitleReferral Specialist
Normalized title-
Department / team-
LocationKalamazoo, MI, United States
Work model-
Employment typeFull Time
Salary-
Statusactive
ATS providerADP Workforce Now Recruiting
Posted / first seen2026-06-01 / 2026-06-02
Changed / last seen2026-06-06 / 2026-06-06

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Company breakdownsRole, location, ATS, and work model facets for this company.Open
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Provider filtered searchThe same provider as a filtered job collection.Open
City jobsActive postings in Kalamazoo.Open
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Linked records

Company726f2022 6a92 400a 8c35 Ffee81e324bd 19000101 000001
Source174f8997-7c88-4043-9186-e71a3e4b3b0a
ATS providerADP Workforce Now Recruiting

Description

JOB TITLE: Referral Specialist DEPARTMENT: Clinical REPORTS TO: Director of Quality, Risk Management, and Compliance FLSA STATUS: Non-exempt, Hourly LOCATION: Alcott POSITION SUMMARY: The Referral Specialist supports continuity and coordination of care by acting as a liaison between patients, providers, internal departments, specialty services, and payers for services not completed during the concurrent patient visit. This role is responsible for initiating, tracking, and closing the loop on all departmental referrals within established timelines, obtaining and managing prior authorizations for medications, diagnostic testing, and procedures, and ensuring clear, timely communication and documentation across the care team and with patients. The Referral Specialist works closely with providers, nursing, clinical support staff, specialty offices, and health plans to ensure referrals are completed accurately, efficiently, and in compliance with organizational policies and payer requirements. Performs other duties as assigned or required. DUTIES AND RESPONSIBILITIES: Referral Coordination and Loop Closure Initiate, track, and ensure loop closure of all internal and external departmental referrals within defined timelines, in accordance with referral follow-up procedures. Monitor open, pending, incomplete, or overdue referrals in the referral/order tracking system to ensure continuity of care and timely patient follow-up. Maintain an accurate referral tracking database and referral logs, ensuring receipt of specialist reports, test results, and consult notes. Proactively follow up with specialty offices, diagnostic centers, and internal departments to obtain missing documentation or results needed to close referrals. Escalate delays, barriers, or breakdowns in referral completion to providers and leadership as appropriate. Prior Authorizations and Appeals Obtain prior authorizations from health plans for medications, procedures, imaging, and diagnostic testing by submitting required clinical documentation via electronic portals, fax, or telephone. Track authorization status and ensure approvals, denials, and requests for additional information are addressed promptly. Coordinate with providers to supply clinical justification and supporting documentation for prior authorization requests. Initiate and track appeals for denied prior authorizations, including resubmission of documentation and coordination with providers as needed. Communicate payor determinations clearly and timely to providers, care teams, and patients. Communication and Care Coordination Communicate with patients and referral sources via telephone, mail, electronic messaging, and other approved methods to notify them of referral status, scheduled appointments, authorization outcomes, and next steps—well in advance of appointment dates when possible. Communicate with specialty offices to obtain all pertinent referral information, scheduling details, and clinical requirements. Serve as a point of contact for internal and external staff to resolve pending, denied, or otherwise problematic referrals and authorizations. Communicate promptly with providers regarding referral issues, authorization challenges, payer determinations, or patient decisions that may affect care plans. Ensure clear, consistent, and thorough communication across the care team from front desk to clinical staff to providers and with patients, supporting patient understanding and engagement in their care. Documentation and Compliance Ensure all referral, authorization, and appeal activities are accurately, timely, and thoroughly documented in the electronic health record and applicable tracking systems. Manage incoming and outgoing fax communications related to referrals, authorizations, clinical documentation, and specialist reports, ensuring documents are properly indexed, routed, and retained according to policy. Adhere to organizational policies, payer requirements, and regulatory standards related to referrals, authorizations, patient privacy, and documentation. Assure quality of care by following evidence-based care guidelines, supporting continuity of care, and complying with state, federal, and other governing agency regulations. Professional Responsibilities Participate in FHC employee engagement activities, organizational initiatives, and community events as requested. Maintain professional and technical knowledge by attending educational workshops, staff meetings, trainings, and clinical committees as required. Perform other duties as assigned to support clinic operations, patient access, and continuity of care. TYPICAL WORKING CONDITIONS: While performing the duties of this Job, the employee is regularly exposed to airborne particles or may be exposed to blood borne pathogens The noise level in the work environment is usually quiet TYPICAL PHYSICAL DEMANDS: While performing the duties of this Job, the employee is regularly required to use hands to finger, handle, or feel and talk or listen The employee is frequently required to stand and walk The employee is occasionally required to sit; reach with hands and arms and stoop and kneel The employee must occasionally lift and/or move up to 25 pounds Specific vision abilities required by this job include close vision, color vision and ability to adjust focus QUALIFICATIONS: Insurance coding and medical terminology Medical Office Experience Familiarity with insurance programs, preauthorization and/or referrals Effectively uses Healthcare information systems, such as electronic health record and practice management systems experience Multi-line phone proficiency Knowledge of medical terminology Experience in customer service, organizational skills, clinical processes, programs and strong computer skills are highly preferred EDUCATION/EXPERIENCE/CERTIFICATIONS/LICENSES: High School Diploma or GED, required Medical Assistant or Certified Nursing Assistant preferred Associate’s Degree from an accredited college or university is preferred Experience in a healthcare setting or an equivalent combination of education and experience in a healthcare setting, 1-2 years preferred Bilingual (English and Spanish) highly desired

Full job record

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Source ID174f8997-7c88-4043-9186-e71a3e4b3b0a
Board ID174f8997-7c88-4043-9186-e71a3e4b3b0a
Provideradp_workforcenow
Provider Job Key593664
TitleReferral Specialist
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Statusactive
Activeyes
Location TextKalamazoo, MI, US, Kalamazoo, MI
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Employment Typefull_time
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CountryUnited States
RegionMI
CityKalamazoo
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Source URLhttps://workforcenow.adp.com/mascsr/default/mdf/recruitment/recruitment.html?cid=726f2022-6a92-400a-8c35-ffee81e324bd&ccId=19000101_000001&lang=en_US&type=JS&jobId=593664&jwId=9202918188341_1
Apply URLhttps://workforcenow.adp.com/mascsr/default/mdf/recruitment/recruitment.html?cid=726f2022-6a92-400a-8c35-ffee81e324bd&ccId=19000101_000001&lang=en_US&type=JS&jobId=593664&jwId=9202918188341_1
First Seen At2026-06-02 08:26:38Z
Last Seen At2026-06-06 20:37:18Z
Last Checked At2026-06-06 20:37:18Z
Last Changed At2026-06-06 20:37:18Z
Inactive At—
Source Posted At2026-06-01 21:39:00Z
Source Updated At—
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    "requisitionDescription": "<div><div><div><p style='margin:0in;font-size:16px;font-family:\"Arial\",sans-serif;margin-right:1.0in;' data-pasted=\"true\"><strong><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>JOB TITLE: </span></strong><strong><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>Referral Specialist </span></strong></p><p style='margin:0in;font-size:16px;font-family:\"Arial\",sans-serif;margin-right:1.0in;'><strong><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>DEPARTMENT: </span></strong><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>Clinical</span></p><p style='margin:0in;font-size:16px;font-family:\"Arial\",sans-serif;margin-right:1.0in;'><strong><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>REPORTS TO: </span></strong><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>Director of Quality, Risk Management, and Compliance</span></p><p style='margin:0in;font-size:16px;font-family:\"Arial\",sans-serif;margin-right:1.0in;'><strong><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>FLSA STATUS: </span></strong><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>Non-exempt, Hourly</span></p><p style='margin:0in;font-size:16px;font-family:\"Arial\",sans-serif;margin-right:1.0in;'><strong><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>LOCATION: </span></strong><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>Alcott</span></p><p style='margin:0in;font-size:16px;font-family:\"Arial\",sans-serif;text-align:justify;'><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>&nbsp;</span></p><p style='margin:0in;font-size:16px;font-family:\"Arial\",sans-serif;text-align:justify;'><strong><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>POSITION SUMMARY:</span></strong><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>&nbsp;&nbsp;</span></p><p style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:16px;font-family:\"Aptos\",sans-serif;' data-pasted=\"true\">The Referral Specialist supports continuity and coordination of care by acting as a liaison between patients, providers, internal departments, specialty services, and payers for services not completed during the concurrent patient visit. This role is responsible for initiating, tracking, and closing the loop on all departmental referrals within established timelines, obtaining and managing prior authorizations for medications, diagnostic testing, and procedures, and ensuring clear, timely communication and documentation across the care team and with patients. The Referral Specialist works closely with providers, nursing, clinical support staff, specialty offices, and health plans to ensure referrals are completed accurately, efficiently, and in compliance with organizational policies and payer requirements. Performs other duties as assigned or required.</p><p style='margin:0in;font-size:16px;font-family:\"Arial\",sans-serif;text-align:justify;'><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>&nbsp;</span></p><p data-pasted=\"true\"><strong>DUTIES AND RESPONSIBILITIES:</strong></p><p><strong>Referral Coordination and Loop Closure</strong></p><ul type=\"disc\"><li>Initiate, track, and ensure loop closure of all internal and external departmental referrals within defined timelines, in accordance with referral follow-up procedures.</li><li>Monitor open, pending, incomplete, or overdue referrals in the referral/order tracking system to ensure continuity of care and timely patient follow-up.</li><li>Maintain an accurate referral tracking database and referral logs, ensuring receipt of specialist reports, test results, and consult notes.</li><li>Proactively follow up with specialty offices, diagnostic centers, and internal departments to obtain missing documentation or results needed to close referrals.</li><li>Escalate delays, barriers, or breakdowns in referral completion to providers and leadership as appropriate.</li></ul><p><strong>Prior Authorizations and Appeals</strong></p><ul type=\"disc\"><li>Obtain prior authorizations from health plans for medications, procedures, imaging, and diagnostic testing by submitting required clinical documentation via electronic portals, fax, or telephone.</li><li>Track authorization status and ensure approvals, denials, and requests for additional information are addressed promptly.</li><li>Coordinate with providers to supply clinical justification and supporting documentation for prior authorization requests.</li><li>Initiate and track appeals for denied prior authorizations, including resubmission of documentation and coordination with providers as needed.</li><li>Communicate payor determinations clearly and timely to providers, care teams, and patients.</li></ul><p><strong>Communication and Care Coordination</strong></p><ul type=\"disc\"><li>Communicate with patients and referral sources via telephone, mail, electronic messaging, and other approved methods to notify them of referral status, scheduled appointments, authorization outcomes, and next steps&mdash;well in advance of appointment dates when possible.</li><li>Communicate with specialty offices to obtain all pertinent referral information, scheduling details, and clinical requirements.</li><li>Serve as a point of contact for internal and external staff to resolve pending, denied, or otherwise problematic referrals and authorizations.</li><li>Communicate promptly with providers regarding referral issues, authorization challenges, payer determinations, or patient decisions that may affect care plans.</li><li>Ensure clear, consistent, and thorough communication across the care team from front desk to clinical staff to providers and with patients, supporting patient understanding and engagement in their care.</li></ul><p><strong>Documentation and Compliance</strong></p><ul type=\"disc\"><li>Ensure all referral, authorization, and appeal activities are accurately, timely, and thoroughly documented in the electronic health record and applicable tracking systems.</li><li>Manage incoming and outgoing fax communications related to referrals, authorizations, clinical documentation, and specialist reports, ensuring documents are properly indexed, routed, and retained according to policy.</li><li>Adhere to organizational policies, payer requirements, and regulatory standards related to referrals, authorizations, patient privacy, and documentation.</li><li>Assure quality of care by following evidence-based care guidelines, supporting continuity of care, and complying with state, federal, and other governing agency regulations.</li></ul><p><strong>Professional Responsibilities</strong></p><ul type=\"disc\"><li>Participate in FHC employee engagement activities, organizational initiatives, and community events as requested.</li><li>Maintain professional and technical knowledge by attending educational workshops, staff meetings, trainings, and clinical committees as required.</li><li>Perform other duties as assigned to support clinic operations, patient access, and continuity of care.</li></ul><p style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;font-size:16px;font-family:\"Arial\",sans-serif;'><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>&nbsp;</span></p><p style='margin:0in;font-size:16px;font-family:\"Arial\",sans-serif;text-align:justify;'><strong><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>TYPICAL WORKING CONDITIONS: &nbsp;</span></strong></p><ul style=\"margin-bottom:0in;margin-top:0in;\" type=\"disc\"><li style=\"margin:0in;font-size:16px;font-family: initial;text-align:justify;\"><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>While performing the duties of this Job, the employee is regularly exposed to airborne particles or may be exposed to blood borne pathogens</span></li><li style=\"margin:0in;font-size:16px;font-family: initial;text-align:justify;\"><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>The noise level in the work environment is usually quiet</span></li></ul><p style='margin:0in;font-size:16px;font-family:\"Arial\",sans-serif;text-align:justify;'><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>&nbsp;</span></p><p style='margin:0in;font-size:16px;font-family:\"Arial\",sans-serif;text-align:justify;'><strong><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>TYPICAL PHYSICAL DEMANDS: &nbsp;</span></strong></p><ul style=\"margin-bottom:0in;margin-top:0in;\" type=\"disc\"><li style=\"margin:0in;font-size:16px;font-family: initial;text-align:justify;\"><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>While performing the duties of this Job, the employee is regularly required to use hands to finger, handle, or feel and talk or listen</span></li><li style=\"margin:0in;font-size:16px;font-family: initial;text-align:justify;\"><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>The employee is frequently required to stand and walk</span></li><li style=\"margin:0in;font-size:16px;font-family: initial;text-align:justify;\"><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>The employee is occasionally required to sit; reach with hands and arms and stoop and kneel</span></li><li style=\"margin:0in;font-size:16px;font-family: initial;text-align:justify;\"><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>The employee must occasionally lift and/or move up to 25 pounds</span></li><li style=\"margin:0in;font-size:16px;font-family: initial;text-align:justify;\"><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>Specific vision abilities required by this job include close vision, color vision and ability to adjust focus</span></li></ul><p style='margin:0in;font-size:16px;font-family:\"Arial\",sans-serif;'><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>&nbsp;</span></p><p style='margin:0in;font-size:16px;font-family:\"Arial\",sans-serif;text-align:justify;'><strong><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>QUALIFICATIONS:</span></strong></p><ul style=\"margin-bottom:0in;margin-top:0in;\" type=\"disc\"><li style=\"margin:0in;font-size:16px;font-family: initial;text-align:justify;\"><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>Insurance coding and medical terminology</span></li><li style=\"margin:0in;font-size:16px;font-family: initial;text-align:justify;\"><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>Medical Office Experience</span></li><li style=\"margin:0in;font-size:16px;font-family: initial;text-align:justify;\"><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>Familiarity with insurance programs, preauthorization and/or referrals</span></li><li style=\"margin:0in;font-size:16px;font-family: initial;text-align:justify;\"><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>Effectively uses Healthcare information systems, such as electronic health record and practice management systems experience</span></li><li style=\"margin:0in;font-size:16px;font-family: initial;text-align:justify;\"><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>Multi-line phone proficiency</span></li><li style=\"margin:0in;font-size:16px;font-family: initial;text-align:justify;\"><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>Knowledge of medical terminology&nbsp;</span></li><li style=\"margin:0in;font-size:16px;font-family: initial;text-align:justify;\"><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>Experience in customer service, organizational skills, clinical processes, programs and strong computer skills are highly preferred</span></li></ul><p style='margin:0in;font-size:16px;font-family:\"Arial\",sans-serif;text-align:justify;'><span style=\"font-size:15px;\">&nbsp;</span></p><p style='margin:0in;font-size:16px;font-family:\"Arial\",sans-serif;text-align:justify;'><strong><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>EDUCATION/EXPERIENCE/CERTIFICATIONS/LICENSES:</span></strong></p><ul style=\"margin-bottom:0in;margin-top:0in;\" type=\"disc\"><li style=\"margin:0in;font-size:16px;font-family: initial;text-align:justify;\"><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>High School Diploma or GED, required</span></li><li style=\"margin:0in;font-size:16px;font-family: initial;text-align:justify;\"><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>Medical Assistant or Certified Nursing Assistant preferred</span></li><li style=\"margin:0in;font-size:16px;font-family: initial;text-align:justify;\"><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>Associate&rsquo;s Degree from an accredited college or university is preferred</span></li><li style=\"margin:0in;font-size:16px;font-family: initial;text-align:justify;\"><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>Experience in a healthcare setting or an equivalent combination of education and experience in a healthcare setting, 1-2 years preferred</span></li><li style=\"margin:0in;font-size:16px;font-family: initial;text-align:justify;\"><span style='font-size:15px;font-family:\"Calibri\",sans-serif;'>Bilingual (English and Spanish) highly desired</span></li></ul></div></div></div>\n",
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      ]
    },
    "requisitionTitle": "Referral Specialist",
    "clientRequisitionID": "2634",
    "organizationalUnits": [],
    "postingInstructions": [],
    "additionalProperties": {},
    "requisitionLocations": [
      {
        "address": {
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          "postalCode": "49001",
          "countrySubdivisionLevel1": {
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        },
        "nameCode": {
          "shortName": " Kalamazoo, MI, US"
        },
        "aliasNames": []
      }
    ],
    "screeningRequirements": [],
    "sponsoredVisaTypeCodes": []
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  "detail_meta": {
    "url": "https://workforcenow.adp.com/mascsr/default/careercenter/public/events/staffing/v1/job-requisitions/593664?cid=726f2022-6a92-400a-8c35-ffee81e324bd&ccId=19000101_000001&lang=en_US&locale=en_US",
    "http_status": 200,
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}
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GET https://api.bluedoor.sh/job-postings/v1/orgs/bab00d1f-adb3-486b-8145-536500e34d80JSON
GET https://api.bluedoor.sh/job-postings/v1/sources/174f8997-7c88-4043-9186-e71a3e4b3b0aJSON
GET https://api.bluedoor.sh/job-postings/v1/jobs/cf16f9083649b853918d3cd616ec71204105c8c2/eventsJSON

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