Clinical Support RN – Referrals & Results

This is a fully remote position, open to applicants in California, +1 more state.

📋 Description

• Oversee clinical inboxes, emails, and faxes to monitor lab results, diagnostic findings, referrals, and patient communications.

• Evaluate lab and diagnostic results, identifying any abnormal, urgent, or critical findings.

• Elevate urgent or critical results to the designated physician in accordance with established protocols.

• Track abnormal results and follow-up tasks until they are addressed appropriately.

• Execute defined physician-directed clinical tasks under approved protocols or standing orders, adhering to the scope of practice.

• Relay physician-approved follow-up instructions to patients effectively.

• Conduct post-visit clinical follow-ups, including symptom checks, coordination of repeat testing, medication-related follow-ups, and other assigned clinical tasks.

• Manage and process incoming referrals from physicians and PAs.

• Triage and prioritize referrals based on urgency, completeness, and medical necessity.

• Research and determine suitable specialists or clinics based on clinical needs, location, insurance eligibility, and availability.

• Prepare and submit prior authorizations and insurance-related documentation.

• Assist patients in scheduling referrals and finding facilities or specialists that accept their insurance.

• Monitor referrals until completion and ensure that consultation notes and recommendations are returned to the clinical team.

• Maintain referral tracking systems, databases, and directories of specialists.

• Document actions, communications, and follow-up plans within the EMR system.

• Address patient inquiries related to referrals, lab results, and follow-up care.

• Support chronic care management and other longitudinal care programs as required.

• Monitor and respond to Slack, email, and designated work queues during scheduled hours.

• Ensure compliance with HIPAA regulations and protect patient confidentiality.

• Participate in virtual team and medical meetings.

⛳️ Requirements

• Valid Registered Nurse (RN) license in the state where services are rendered.

• Minimum of 2 years' experience in clinical nursing, ambulatory care, primary care, care coordination, referral management, or a related role.

• Certification in HIPAA compliance.

• Strong grasp of medical terminology, specialties, lab result interpretation, and medication management.

• Experience in reviewing and triaging clinical results.

• Familiarity with referrals, prior authorizations, insurance workflows, or care coordination.

• Experience with EMRs and knowledge of laboratory or clinical portals such as Quest/Quanum.

• Ability to perform physician-directed tasks with professionalism, accuracy, and appropriate clinical judgment.

• Proficiency in Gmail, Excel or Google Sheets, Zoom or Google Meet, Slack, Adobe PDF, and web-based healthcare portals.

• Comfortable working autonomously in a remote setting.

• Reliable home internet connection and a private workspace suitable for handling protected health information.

• Capability to troubleshoot basic technology issues independently.

• Exceptional attention to detail, organizational skills, time management, and documentation abilities.

• Strong written and verbal communication skills with patients, providers, and team members.

• Adaptability to changing workflows and adherence to standardized processes.

• Fluency in English is required; proficiency in a second language such as Spanish is a plus.

• Prior experience in telehealth, virtual care, primary care, or ambulatory care.

• Experience with chronic care management or similar longitudinal care programs.

• Experience executing clinical tasks under physician protocols or standing orders.

• Experience in referral coordination and closed-loop referral workflows.

• Familiarity with medication prior authorizations.

• Experience working with Medicare, Medicaid, and commercial insurance plans.

🏝️ Benefits

• Flexible working hours.

• Remote work arrangement.