Referrals Lead

ESSENTIAL FUNCTIONS

• Utilize advanced expertise in referral processes, insurance requirements, and medical terminology to resolve complex cases and ensure accuracy and compliance in referral processing

• Provide coordination and operational support to Referrals Specialists, including guiding referral workflows, supporting team decision-making, delegating tasks, and ensuring appropriate coverage to maintain productivity and service levels

• Assist in onboarding and coordinating training for new and existing team members

• Accurately document, process, and manage a high volume of referrals-related tasks (including referrals, orders, follow-ups, documents, and calls/voicemails) within the EMR system in accordance with established procedures and quality standards

• Monitor and manage referral queues to ensure timely processing, follow-up, and completion

• Effectively communicate and collaborate with patients, care teams, medical offices, and insurance providers to obtain information, resolve issues and support referral completion

• Address patient concerns or complaints and assist with resolution in collaboration with the team

• Identify workflow inefficiencies and contribute to process improvement initiatives, and escalate operational or employee concerns as appropriate

• Assist with quality reviews and audits of referral work to ensure adherence to workflows, accuracy, and compliance standards

• Act as a resource for internal departments regarding referral processes and best practices

• Perform additional duties as assigned by management

JOB REQUIREMENTS

• High School Diploma or equivalent required

• Minimum of 3 years of referral-related experience in a medical office setting required

• Knowledge of healthcare insurance plans preferred; strong understanding of medical terminology desired

• Experience with electronic medical records (EMR) systems preferred

• Demonstrated ability to communicate effectively, both verbally and in writing, with patients, staff, and external partners

• Strong analytical, problem-solving, and critical thinking skills with close attention to detail

• Excellent organizational skills with the ability to prioritize and manage multiple tasks accurately in a fast-paced environment

• Strong customer service skills with the ability to support patients using professionalism, empathy, and compassion

• Sound judgment and decision-making ability, including professional phone etiquette and active listening skills

• Proficiency with Windows-based computer applications and ability to efficiently navigate systems while multitasking (e.g., typing while on calls)

• Ability to work both independently and collaboratively as part of a team, with flexibility in a dynamic environment

• Ability to meet and maintain established productivity, performance, and quality metrics

• Ability to review work for accuracy and provide constructive feedback

• Experience training or mentoring staff preferred

• Ability to consistently uphold HIPAA and patient confidentiality standards

• Commitment to demonstrating and upholding InterMed’s Values

• State of Maine residency required

• Professional appearance and conduct required

• On-site, in-person training required (approximately 4–6 weeks, based on performance and quality)
  
  

  DISCLAIMER: This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of this position. Duties, responsibilities and activities may change, or new ones may be assigned at any time with or without notice.