Referral Specialist (Full-time, Days)
About The Position
The Referral Specialist coordinates and schedules diagnostic testing, specialty procedures, and referrals while obtaining required insurance authorizations and pre-certifications. The role is a liaison among patients, providers, insurance companies, and healthcare facilities to help ensure timely access to care. It maintains accurate records in the electronic medical record (EMR), communicates testing instructions to patients, and supports an exceptional patient experience through customer service and attention to detail. This is a full-time, 40-hour-per-week position with a Monday–Friday schedule from 7:30 a.m. to 4:00 p.m. The job posting identifies the role as hybrid and lists its location as 30 Hagen Drive, Suite 100, Rochester, NY 14625.
Requirements
- High school diploma or GED required.
- At least one year of experience in a healthcare, medical office, scheduling, registration, or insurance authorization environment is preferred.
- Proficiency with Microsoft Office applications, including Word and Excel, and ability to navigate multiple computer systems.
- Strong organizational, communication, and customer service skills.
- Ability to multitask, prioritize competing responsibilities, and work efficiently in a fast-paced environment.
- Strong attention to detail and accuracy when working with patient records, insurance information, and scheduling.
- Ability to maintain confidentiality and demonstrate professionalism when interacting with patients, providers, and staff.
Nice To Haves
- Associate degree in a healthcare-related field.
- Experience obtaining insurance authorizations and pre-certifications.
- Knowledge of medical terminology.
- Orthopedic terminology experience, strongly preferred.
- Experience working with electronic medical records (EMR/EHR).
- Familiarity with diagnostic imaging, specialty testing, and referral coordination.
- Experience working with insurance carriers, payer requirements, and medical necessity documentation.
Responsibilities
- Coordinate scheduling for diagnostic imaging, specialty testing, and physician referrals, including MRI, CT, Neurology, Pain Management, and other specialized services.
- Obtain insurance authorizations and pre-certifications by submitting required clinical documentation and working directly with insurance carriers.
- Review physician orders and medical documentation for accuracy and completeness before scheduling.
- Verify procedure and diagnosis codes required for authorization requests.
- Communicate with physicians, patients, healthcare facilities, and insurance companies to coordinate timely care.
- Notify patients of scheduled appointments, testing instructions, preparation requirements, and arrival times.
- Document authorization information, patient communications, and payer interactions in the electronic medical record (EMR).
- Assist self-pay and out-of-network patients by connecting them with appropriate financial resources.
- Maintain current knowledge of scheduling workflows, insurance authorization requirements, and departmental policies and procedures.
- Operate standard office equipment and electronic systems, including EMR software, telephones, printers, copiers, and fax machines.
- Greet and assist patients professionally in person and by telephone, delivering exceptional customer service.
- Support continuous process improvement and perform additional duties as assigned to promote efficient practice operations.
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What This Job Offers
Job Type
Full-time
Education Level
High school or GED
