Lead Referral Clerk

  • Job Tracking ID: 512937-903548
  • Job Location: Fall River, MA
  • Job Level: Entry Level (less than 2 years)
  • Level of Education: Any
  • Job Type: Full-Time/Regular
  • Date Updated: October 14, 2025
  • Years of Experience: Any
  • Starting Date: ASAP



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Job Description:

We’re more than just quality treatment for substance use disorders. We’re a total health community. At SSTAR, our mission is healing the community, one person at a time. We will provide a personal level of healthcare and addiction treatment that addresses the mental, physical, and spiritual well-being of everyone we touch. SSTAR is a Federally Qualified Health Center (FQHC) which affords our employees eligibility to apply for one of our three Loan Repayment Programs. 

The Lead Referral Clerk serves as the primary liaison for both staff and patients, ensuring clear communication and support throughout the referral process. This role oversees and manages the entire referral workflow to guarantee efficient coordination of patient care. 

Benefits

  • 403B
  • Dental insurance
  • Disability insurance through Massachusetts PFML
  • Employee discounts, cell phone, eyewear etc.
  • Health insurance
  • Life insurance
  • Paid time off
  • Vision insurance
  • Flexible Spending Account
  • Opportunities to earn CEU's
  • Voluntary Benefits including but not limited to, Disability, Life, Critical Illness, Accident and Disability Insurances

Duties & Responsibilities

  • Schedule, communicate, and coordinate referral appointments and diagnostic testing with outside specialists and patients.
  • Prioritizes referrals by their urgency and addresses in a timely manner.
  • Track and maintain accurate records of external referral appointments.
  • Fax and/or scan referral order and required information to specialists and hospitals.
  • Answer and respond to phone calls and requests for information.
  • Contacts insurance companies to ensure prior approval requirements are met. Presents necessary medical information such as history, diagnosis and prognosis to insurance company if deemed necessary to prove medical necessity of services. (WAS: Process insurance referrals and prior authorizations.)
  • Communicates with providers/staff for information, records, and assistance.

Experience and Skills:

  • High school diploma required.
  • 3-5 years experience in referrals required
  • Experience in verifying insurance eligibility
  • Experience obtaining/processing insurance referrals and diagnostic prior authorizations.
  • Experience working in a medical office setting
  • Knowledge of medical terminology, CPT code, HIPAA & 42 CFR