The Referral Authorization Specialist assures that all referrals are managed effectively and efficiently. Provides high-level customer service to both referring physicians as well as referred patients. Obtains pre-authorization for patient appointments, all diagnostic tests and performs additional administrative support functions. This job requires the application and interpretation of policies and procedures and the use of independent judgment in a medical setting. The individual must possess the ability to maintain a working knowledge of carrier contracts/changes and departmental policies and procedures. The Referral Authorization will also be responsible for providing customer service support and ensuring that all requests are handled in a timely manner.

Responsibilities:

• Assures all referrals are handled effectively and efficiently.
• Analyzes information required to complete pre- authorizations with referring physician offices, insurance carriers and service area contacts.
• Demonstrates the skills of effective communication, decision-making and organization to ensure efficient job performance and job success.
• Provides high-level customer service to both referring physicians as well as referred patients.
• Assists with operational patient flow as applicable; performs problem-solving.
• Maintains current working knowledge; adheres to Medical Center and departmental policies and procedures.
• Provides service in a professional and courteous manner.
• Performs area-specific support activities.
• In addition to the above job responsibilities, other duties may be assigned.

Personal Attributes:

• A strong representative of the organization’s values.
• Highly accountable individual with demonstrated ability to take ownership of role, driving towards measurable outcomes.
• Must be very organized with professional communication standards.
• Must maintain confidentiality standards.
• Maintains a professional attitude and high work standards.
• Must be a team player.
• Adaptable, dynamic thinking individual with strong problem-solving skills.

Required Qualifications:

• 1 year of Medical RCM Experience
• High School Diploma required; Associate Degree preferred.

Job Type: Full-time

Pay: $15.00 - $16.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible schedule
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Retirement plan
• Vision insurance

Experience:

• RCM: 1 year (Required)

Work Location: In person