Referral & Authorization Specialist - Care Lane Hematology/Oncology Clinic

Glens Falls Hospital • Saratoga Springs, NY

4d

About The Position

Glens Falls Hospital is hiring a Referral & Authorization Specialist for the Care Lane Hematology/Oncology Clinic. The role connects oncology patients, providers, and insurance payers, helping patients access cancer treatments while reducing insurance-related stress. It also offers an opportunity to develop skills in medical billing, compliance, and Health Information Management (HIM).

The specialist verifies insurance eligibility and medical necessity, obtains prior authorizations, helps patients understand their benefits and financial obligations, and supports clinic staff with authorization questions and workflow needs. The role also follows up on referrals and denials and prepares accurate supporting documentation, including medical records, clinical notes, and coding information.

Requirements

• High school diploma or GED equivalent.
• Exceptional customer service skills.
• Ability to multitask.
• Strong verbal and written communication skills.
• Excellent computer proficiency.

Nice To Haves

• Associate degree (AAS) in Health Administration, Business, Finance, or a related field.
• Four years of healthcare insurance experience; experience may substitute for an associate degree.
• Familiarity with medical terminology, CPT/ICD coding, and Medicare or third-party regulations.
• Fast and accurate typing skills; 60 WPM preferred.

Responsibilities

• Verify patient insurance eligibility, check medical necessity guidelines, and obtain prior authorizations from payers.
• Counsel patients on insurance benefits, financial obligations, and coverage questions.
• Serve as a central point of contact for clinic staff regarding authorizations.
• Stay updated on procedure guidelines and assist with monitoring patient waiting workflows when needed.
• Provide clinical staff with guidance on authorization rules and notify providers of insurance obstacles.
• Track ongoing referrals and lead follow-up on insurance denials to secure proper reimbursement.
• Compile medical records, clinical notes, and CPT/ICD coding information for accurate documentation.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED