Referral Specialist Lead (Internal Only)

Northwest Human Services, Inc.•Salem, OR

2d•Onsite

About The Position

Northwest Human Services is seeking an experienced Referral Specialist Lead to help patients navigate the healthcare system and access needed care. Based at the West Salem Clinic, this role serves as a technical resource and mentor for the Referrals team, coordinating complex referrals and insurance authorizations and strengthening workflows that support timely, continuous care. The Referral Specialist Lead works with providers, patients, specialists, insurance partners, and leadership to promote a positive patient experience. This position provides day-to-day technical guidance, coaching, and onboarding support to Referral Specialists; coordinates medical, mental health, and medication pre-authorizations; and facilitates referrals and appointments with specialists and external healthcare facilities. It also supports referral-system troubleshooting and workflow improvements, maintains specialist information and knowledge of payer requirements and coding, and contributes to compliance, confidentiality, patient safety, and quality improvement initiatives. The position is full-time, Monday through Friday, at the West Salem Clinic in Salem, Oregon. It is non-exempt and reports to the Patient Access Team Supervisor.

Requirements

High school diploma or equivalent.
At least two years of experience in clinic referrals.
At least six months of experience working at Northwest Human Services in any capacity using clinical systems.
Proficiency in medical terminology.

Responsibilities

Provide day-to-day technical guidance, coaching, and support to Referral Specialists.
Serve as a subject matter expert for referral processes, pre-authorizations, and department workflows.
Assist with onboarding and training new Referral Specialists.
Support team members with complex or escalated referral and authorization requests.
Initiate and coordinate medical, mental health, and medication pre-authorizations with insurance companies and other third-party payers.
Facilitate timely patient referrals to specialists and external healthcare facilities.
Coordinate patient appointments and interpreter services when needed.
Communicate referral status, authorization requirements, and potential barriers to providers and patients.
Serve as a super user for referral systems and collaborate with IT to troubleshoot issues and improve workflows.
Maintain current knowledge of insurance requirements, payer guidelines, medical terminology, ICD-10, and CPT coding.
Maintain accurate and up-to-date specialist information.
Support compliance, confidentiality, patient safety, and quality improvement initiatives.

Benefits

Medical insurance
Dental insurance
Vision insurance
Group life insurance
Short-term disability insurance, 100% paid by the employer
Long-term disability insurance, 100% paid by the employer
403(b) retirement plan with a 2% employer contribution and up to a 3% employer match
Flex Spending Account
Paid time off: 10 hours per month for full-time positions, increasing to up to 20 hours monthly with tenure
7.5 paid holidays per year and two paid floating holidays for full-time positions
Continuing education and training benefits
Employee Healthy Living Program, including gym membership and smoking cessation