Supervisor, Referral and Authorization

🌟 Supervisor, Referral and Authorization

💰 Salary Range: $20.52-$33.70/hr based on experience and qualifications

💡 About Saratoga Hospital

At Saratoga Hospital, we’ve built a reputation for high-quality, compassionate care and a commitment to the health and well-being of our community. As part of the Albany Med Health System, we combine advanced technology with a deeply personal approach—creating a supportive environment for patients, staff, and providers alike. We believe that exceptional care starts with exceptional people.

🎯 About the Role

We’re looking for a dedicated Supervisor, Referral and Authorization to join our team and help us continue delivering the level of care our patients and families deserve. In this role, the supervisor is responsible for leadership of team members, and coordination of daily operations of the Referral and Authorization team within Patient Engagement Center (PEC), under the direct supervision of the Manager.

The Referral and Authorization Specialist (RAS) is responsible for scheduling and routing referrals, validating medical necessity, and obtaining insurance authorizations to ensure reimbursement for services and testing.

🔍 What You’ll Do

Supervisor Responsibilities:

• Monitors and coordinates the work activities of the unit to meet service goals, while providing exceptional service. Work activities include but are not limited to: phone queues, voicemail boxes, work queues, email groups, and resource/provider schedules. Makes daily work assignments for teams.
• Assists Manager in providing direct support to assigned team members, supporting team members in meeting and exceeding established service goals and performance standards in areas of accuracy, productivity, and the patient experience, while maintaining compliance with departmental and organization policies and procedures and other relevant regulatory guidance.
• Act as the first escalation point for team members within the Patient Engagement Center, assist in troubleshooting and resolving issues, and providing service recovery.
• Acts as a departmental resource by providing training, mentorship, feedback, and assistance in problem solving and process improvement.
• Assists in administering quality assurance functions for the department.
• Provide direct feedback to team members, and provide direct feedback to the Manager to support performance management.
• Assist the Manager in carrying out supervisory responsibilities for the department including hiring, onboarding, staffing, corrective actions, timekeeping, staff scheduling and time off management, and performance evaluations.
• Supports training and professional development of new team members.
• Assist Manager in maintaining and appropriately utilizing tools to support operations of the PEC (issue reporting tool, scheduling reference guides, provider templates, etc.)
• Act as a role model for Referral and Authorization Specialist performance standards.
• Maintains effective communication within the Patient Engagement Center. Leads daily huddles, organize team meetings, and supports effective communication of information between front line teams and the Manager.
• Effectively carries out responsibilities of a Subject Matter Expert (SME) as required.
• Effectively carries out the responsibilities of a practice or hospital department liaison for a specific site as required.

Referral and Authorization Specialist Responsibilities:

• Makes outbound calls to schedule incoming referrals or orders for all practices or modalities within a defined POD.
• Route outgoing referrals and attach relevant documentation to various internal and external locations, and coordinates care at that location.
• Run reports and audit charts to ensure closed loop referrals. Follow up with patients and provider offices to coordinate care and ensure ordered services are completed. Ensures patients and providers receive timely and courteous communications.
• Check authorization requirements with the payer and obtain authorizations utilizing clinical documentation for all payers. 
• Collaborate with the practices and providers when additional clinical documentation is needed to process an authorization, or when a requested service is denied.
• Ensures EMR is appropriately up to date regarding referral status.
• Validate medical necessity.
• Stays informed of insurance payer requirements and policies by reviewing newsletters, websites, etc., and educate colleagues on these requirements.
• Communicates and provides feedback to providers and staff regarding changes, trends, and processes
• Meets Patient Engagement Center service standards and Saratoga Hospital FAMILY Caring Standards.
• Cross-trained in Operator Responsibilities, provides support as needed.
• Answers phone calls for multiple phone lines. Responsible for utilizing protocols to assess needs of the caller, answer questions of the caller, transferring the caller to the appropriate destination, and transcribing messages.
• Assists with clerical tasks including receiving and routing of incoming faxes and documents, entering referrals into the EMR system, running reports and auditing charts to ensure closed loop referrals, and other tasks.
• Performs other duties according to department needs.

📋 What You Bring

• Associates degree preferred, or comparable experience.
• Experience working in a medical office or hospital patient access or customer service setting.
• Medical terminology understanding.
• Experience using a ‘windows based personal computer’ with proficient keyboard entry using a mouse as well as multiple computer programs.
• CHAA (Certified Healthcare Access Associate) Certification Preferred.

🙌 Why Saratoga Hospital

• A caring, community-focused culture rooted in teamwork and trust
• Supportive leadership that invests in your development and well-being
• Comprehensive benefits, including medical, dental, retirement plans, tuition assistance, and wellness programs. Click here to view our complete benefits guide.
• Opportunities to grow within the Albany Med Health System
• Located in beautiful Saratoga Springs, known for its vibrant community, outdoor recreation, and cultural attractions

🤝 Our Commitment

We are an equal opportunity employer and strongly encourage individuals of all backgrounds and experiences to apply. If you’re passionate about healthcare and community service—even if you don’t meet every qualification listed—we’d still love to hear from you.

📝 How to Apply

Click the ‘apply’ button to submit your resume and complete our online application. Applications are reviewed on a rolling basis—apply today and discover what makes Saratoga Hospital a special place to grow your career.