Referral Authorization Specialist

A healthcare organization is seeking to hire a Referral Authorization Specialist. Looking for a candidate who has medical insurance knowledge who can be responsible for reviewing schedules, confirming appointment dates with patients, handling referrals and authorization as needed, etc. The ideal candidate is highly organized, detail orients, and possesses strong communication and interpersonal skills. Additionally, previous experience using EPIC software is highly preferred, but not required.

Responsibilities:

• Works in collaboration with the Patient Care Coordinator to ensure duties are completed.
  
• Coordinate all aspects of referrals ordered by health center providers on behalf of patients.
  
• Ensure client is PCP aligned before working on the referral.
  
• Enter appropriate structured data fields are populated in referral tracking module in electronic medical record.
  
• Maintain communication with the provider and patient regarding the most appropriate specialist to refer to in each case.
  
• Ensure proper paperwork is given to patient for appointment per orders (i.e., labs, x-rays, progress notes).
  
• Track referral appointment outcome in the medical record and bring to the attention of the ordering provider.
  
• Assign patient to securing own appointment based on patient ability and need for support.
  
• Secure insurance authorization as needed.
  
• Obtain consult reports from specialty provider and log in medical record.
  
• Maintain specialty provider list on shared drive including payor sources they accept.
  
• Daily huddle participation, including updates on status of referrals for clients being seen on today s visits.
  

Requirements

• High school diploma or equivalent.
  
• One year of experience in a medical related field preferred.
  
• Interest in and ability to work with culturally diverse populations.
  
• Skilled in interpersonal relationships with a culturally diverse population.
  
• Ability to work occasional evenings and weekends with advance notice.
  
• Strong attention to detail and organization.
  
• Ability to prioritize multiple demands at once.
  
• Experienced with Microsoft Office (Word, Excel), Outlook, and the Internet.
  
• Must possess a high level of interpersonal skills to handle sensitive and confidential client information and situations.