Community Referral Specialist

PruittHealth

. Manage all incoming referrals from selected key referral sources .

Posted 10/7/2026full-timeNorcross • United StatesJuniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in managing patient referrals, evaluating admissions, and collaborating with clinical teams while maintaining compliance with regulatory standards. Proficient in data entry, insurance verification, and utilizing electronic health systems to enhance referral processes.

Highest-signal resume keywords

Referral ManagementData Entry AccuracyInsurance VerificationHealthcare ExperienceRegulatory Compliance

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Data EntryMedical TerminologyElectronic Health SystemsReferral EvaluationInsurance Knowledge

Soft Skills

Strong CommunicationCustomer ServiceCollaborationProblem-SolvingAttention to Detail

Certifications & Qualifications

High School Diploma or Equivalent

Industry Keywords

Healthcare EnvironmentRegulatory AgenciesReimbursement SystemsMedicare CoveragePatient Rights

About the role

Key responsibilities & impact

Manage all incoming referrals from selected key referral sources
Evaluate referrals for admission to PruittHealth using clinical experience and understanding of Home Health agencies
Support Community Relations Representatives in sustaining business partnerships with referral sources
Review patient referrals and respond within productivity response expectations
Complete referral documentation accurately, maintaining a 1% or less data entry error rate
Manage incoming calls and respond before the third ring
Assign the appropriate next person in the referral management process
Verify insurance and eligibility when assigned
Work closely with the clinical team until admission is scheduled
Attend morning huddle calls
Collaborate with the revenue cycle team regarding payors and verification/authorization requirements
Escalate issues or barriers to the manager
Review physician orders and follow up with referral sources for clarification or additional information
Identify objections, concerns, and entry barriers; provide information and offer alternatives when services cannot be provided
Process and document referrals not accepted for admission, including specific reasons
Access multiple electronic health systems to receive referrals
Understand daily agency statuses across staffing, payor, and clinical abilities
Manage points of contact across assigned agencies
Partner with sales partners, administrators, and clinical managers
Support further referral processing, vet payors, and conduct welcome calls when needed
Perform other related duties as directed by the supervisor

Requirements

What you’ll need

High School Diploma or equivalent
One (1) year experience working in a healthcare environment, or any equivalent combination of experience and training which provides the required knowledge, skills, and abilities
Clerical and Computer skills required including experience with data entry
Knowledge of basic medical terminology
Fluent with all Regulatory agencies, reimbursement systems and levels of care
Knowledgeable of private insurance and Medicare coverage criteria, rules and regulations
Ability to learn and use multiple electronic health systems and platforms to receive referrals
Ability to attend and participate in continuing educational programs to keep abreast of changes in the field and maintain current license/certification, as required
Commitment to patient/resident rights, confidentiality, ethical standards, regulatory requirements, accreditation standards, and company policies
Strong communication and customer service abilities with patients, families, visitors, referral sources, and provider networks

Benefits

Comp & perks

Equal Employment Opportunity consideration without regard to race, color, religion, sex, national origin, disability, or veteran status