Referral Specialist

METRO COMMUNITY HEALTH CENTER•Pittsburgh, PA

9d•Onsite

About The Position

The Referral Specialist is responsible for managing referrals and ensuring all necessary documentation and authorizations are in place. This role requires a strong understanding of healthcare administrative processes, insurance verification, and patient confidentiality. The specialist will work in a fast-paced clinical office environment, managing multiple priorities and communicating effectively with patients and healthcare providers.

Requirements

High school diploma or equivalent required.
Minimum of 1–2 years of experience in prior authorization, referral coordination, insurance verification, medical office support, or related healthcare administrative work.
Experience working with electronic medical records or electronic health records.
Familiarity with Medicare, Medicaid, managed care plans, payer requirements, and authorization workflows.
Working knowledge of medical terminology, CPT and ICD-10 codes, referral processes, and insurance documentation requirements.
Strong organizational skills, attention to detail, and ability to follow tasks through to completion.
Excellent verbal and written communication skills, including professional telephone etiquette.
Ability to manage multiple priorities in a fast-paced clinical office environment.
Ability to handle sensitive patient information with professionalism and confidentiality.

Nice To Haves

Certified Medical Assistant credential preferred.
Experience in a primary care, family practice, community health, or federally qualified health center setting preferred.
Experience coordinating referrals for diagnostics, specialty care, labs, durable medical equipment, home health care, or physical therapy preferred.