Referral Specialist

Sweetgrass & SouthernMED Pediatrics•Lexington, SC

29m

About The Position

We value our families we serve, our communities and our team members. As a Referral Specialist you support a positive patient experience by efficiently processing requests for referrals, prior authorizations, and diagnostic imaging. Our Mission At our offices, we do our best each day to provide high quality, compassionate health care to the families in our communities, treating each child as our own. Our staff and providers strive to make each encounter pleasant and informative while respecting the time and individual needs of our patients and families.

Requirements

High school diploma or equivalent required; associate or bachelor's degree preferred.
Minimum 1–2 years of credentialing experience, preferably in a pediatric or outpatient healthcare setting.
Knowledge of credentialing processes, insurance payers, and regulatory standards (e.g., CAQH, Medicare, Medicaid).
Strong organizational skills with high attention to detail.
Excellent written and verbal communication skills.
Proficiency with credentialing software, Microsoft Office (Word, Excel, Outlook), and practice management systems.
Ability to work independently and manage multiple deadlines simultaneously.
Indoor, temperature controlled, smoke free environment.
May at times work under stressful situations.
Handicapped accessible.

Nice To Haves

associate or bachelor's degree preferred.

Responsibilities

Facilitates outgoing referral requests which include obtaining prior authorization when necessary.
Obtains prior authorization for patient medications.
Schedules and obtains prior authorization for diagnostic imaging requests.
Meets position requirements and performs essential functions.
Completes all mandatory training as required.
Performs other duties as assigned.