Referral Specialist (Full-time, Days)

Summary

The Authorization & Scheduling Coordinator is responsible for scheduling and obtaining insurance authorizations/pre-certifications for MRI CT Neurology Pain Management and other specialized testing as well as referrals to physician specialists. This role ensures all patient and third-party interactions are accurately documented in the electronic medical record (EMR) system while promoting excellent customer service and appropriate patient care coordination.

Responsibilities

• Greet and assist patients in person and over the phone with a positive and helpful attitude

• Coordinate diagnostic testing and referrals between physicians patients facilities and insurance payers

• Review medical documentation for accuracy and completeness prior to scheduling and authorization

• Obtain procedure and diagnosis codes necessary for insurance authorization and pre-certification

• Complete insurance authorization/pre-certification requests and submit required supporting documentation

• Document authorization details including approval information and insurance contact details within the EMR

• Notify patients of scheduled appointments procedures preparation instructions and arrival times

• Coordinate scheduling details with hospitals and testing facilities

• Assist with reviewing and updating scheduling-related policies and procedures

• Maintain working knowledge of office equipment including telephones computers printers copiers and fax machines

• Support operational efficiency by performing additional administrative duties as needed

• Ensure patient interactions are age-appropriate and culturally sensitive

Required Qualifications

• High school diploma or GED required

Preferred Qualifications

• Associate degree (AAS) in a related field preferred

• Previous medical office or healthcare scheduling experience preferred

• Proficiency in Microsoft Word and Excel

• Familiarity with EMR systems and healthcare documentation practices preferred

• Orthopedic terminology highly preferred

• Experience obtaining insurance authorizations and pre-certifications preferred

EDUCATION:

LICENSES / CERTIFICATIONS:

PHYSICAL REQUIREMENTS:

For disease specific care programs refer to the program specific requirements of the department for further specifications on experience and educational expectations including continuing education requirements.

Any physical requirements reported by a prospective employee and/or employees physician or delegate will be considered for accommodations.

PAY RANGE:

The listed base pay range is a good faith representation of current potential base pay for a successful full time applicant. It may be modified in the future and eligible for additional pay components. Pay is determined by factors including experience relevant qualifications specialty internal equity location and contracts.

Rochester Regional Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race color creed religion sex (including pregnancy childbirth and related medical conditions) sexual orientation gender identity or expression national origin age disability predisposing genetic characteristics marital or familial status military or veteran status citizenship or immigration status or any other characteristic protected by federal state or local law.