Referral & Authorization Specialist

About Us

Since 1974, Associated Retina Consultants has an experienced team of Arizona eye specialists to diagnose and treat your vision problem. Our focus is on the retina, macula, and the vitreous humor in the eye. We work hard every day to protect and save our patients vision, helping them lead better quality lives.

Position Summary:

The Referral & Authorization Specialist is responsible for coordinating, processing, and tracking patient referrals and prior authorizations to ensure timely access to care and financial clearance. This role serves as a key liaison between providers, patients, payers, and internal teams, maintaining compliance with payer guidelines and supporting seamless continuity of care. The position also plays a critical role in medication benefit investigations, patient assistance programs, and inherited retinal disease–related care coordination. 

Essential Functions:

• Process and manage incoming and outgoing referrals.
• Obtain, submit, and track prior authorizations for visits, procedures, imaging, injections, medications, and specialty services.
• Review referral and authorization documentation for completeness and accuracy.
• Monitor authorization status and follow up with insurance payers as needed.
• Review schedules in advance to confirm financial clearance and resolve authorization or benefit issues prior to appointments.
• Communicate authorization delays or barriers with scheduling, front office, and call center teams.
• Accurately document referrals, authorizations, benefit investigations, and communications in the EMR/PM system.
• Address authorization-related denials and resubmit documentation as needed.
• Coordinate benefit investigations, patient financial responsibility, and patient assistance programs when applicable.
• Manage referrals and authorizations for specialized and external services.
• Serve as a liaison between providers, patients, payers, and internal departments to ensure continuity of care.
• Escalate complex cases as appropriate and support workflow improvements.
• Maintain regular, predictable attendance and punctuality.
• Perform other related duties as assigned

Salary: Commensurate with experience.

Benefits: Medical, Dental, Vision, Life Insurance, Disability Insurance, Paid Holidays, Vacation and Sick Time and much more.

Skills & Qualifications:

• High school graduate or equivalent.
• At least 2 years of referral/authorization processing experience in a medical setting preferred.
• Experience working with electronic medical records preferred.
• Excellent verbal and written communication skills.
• Strong computer skills and proficiency in Microsoft Office 365 or similar software.
• Ability to work well as a team player and collaborate effectively with internal staff.
• Strong planning and organizing skills to manage a high volume of referrals and ensure timely processing.
• Ability to work independently and take initiative while maintaining patient confidentiality and handling sensitive matters with discretion and tact.

Physical Demands:

• The employee is required to sit for prolonged periods of time while performing the duties of this job.
• May occasionally be required to lift 10 to 25 lbs.
• The employee is occasionally required to use hands to finger, handle, or feel and reach with hands and arms.
• The employee must frequently lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, depth perception and ability to adjust focus.
• Normally works in a general office environment with the use of computer, printer, telephone, copier, fax, and calculator. Lighting and temperature are adequate, possible exposure to staff or patients with communicable diseases and blood borne pathogens.

The Company has reviewed this job description to ensure that essential functions and basic duties have been included. It is intended to provide guidelines for job expectations and the employees ability to perform the position described. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate. This document does not represent a contract of employment, and the Company reserves the right to change this job description and/or assign tasks for the employee to perform, as the Company may deem appropriate.

Associated Retina Consultants is an Equal Opportunity Employer.