Community Referral Specialist

PruittHealth

. Manage incoming referrals from 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 proficiency in managing patient referrals, verifying insurance eligibility, and collaborating with clinical and revenue cycle teams. Maintains high standards of data accuracy and confidentiality while navigating multiple electronic health systems.

Highest-signal resume keywords

Referral ManagementInsurance VerificationData Entry AccuracyHealthcare ExperienceMedical Terminology Knowledge

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Data EntryReferral DocumentationInsurance Eligibility VerificationBasic Medical TerminologyRegulatory Knowledge

Soft Skills

CollaborationCommunicationProblem-SolvingAttention to Detail

Tools & Technologies

Electronic Health Systems

Industry Keywords

Healthcare EnvironmentPrivate InsuranceMedicare CoverageReimbursement SystemsConfidentiality Compliance

About the role

Key responsibilities & impact

Manage incoming referrals from key referral sources
Evaluate referrals for admission to PruittHealth
Review patient referrals and respond within productivity expectations
Complete referral documentation and maintain 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 with the clinical team until admission is scheduled
Attend morning huddle calls
Collaborate with the revenue cycle team on payors and verification/authorization requirements
Escalate issues or barriers to the manager
Review physician orders and obtain clarifications or additional information
Identify objections, concerns, and entry barriers; provide information and alternatives
Process and document referrals not accepted for admission
Access multiple electronic health systems to receive referrals
Monitor agency statuses across staffing, payor, and clinical abilities
Partner with sales partners, administrators, and clinical managers
Support 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 equivalent combination of experience and training
Clerical and computer skills, including data entry
Knowledge of basic medical terminology
Knowledge of private insurance and Medicare coverage criteria, rules and regulations
Knowledge of regulatory agencies, reimbursement systems, and levels of care
Ability to learn and use multiple electronic health systems and platforms
Must comply with the Code of Conduct, state and federal regulations, accreditation standards, and policies and procedures
Must maintain confidentiality of patient and employee records and information

Benefits

Comp & perks

Equal Employment Opportunity employer
Continuing educational programs to keep abreast of changes in the field and maintain current license/certification, as required