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Referral Specialist

$16.83 - $23.77 per hour

CHI

Job Summary And Responsibilities As our Referral Specialist, you will orchestrate patient access to specialized care by expertly managing all referral and authorization processes. Every day, you will proactively obtain clearances for specialty visits, issue referrals for ancillary services (consults, imaging, labs), and secure approvals for medications, DME, home health, and other vital services. To be successful in this role, you will demonstrate meticulous attention to detail, strong organizational skills, and clear communication to ensure seamless and efficient service delivery for our patients. Responsibilities Gather, verify, and process orders for tests, referrals, authorizations, and pre-certifications by working closely with physicians, patients, and payers. Communicate detailed information and answer patients’ questions regarding their health care plan; provide answers to billing and insurance clarification questions. Set up appointments, coordinate clinic visits, and any special arrangements such as transportation, interpreter services, specialty care, etc. Communicate or provide written material to patients with referral information such as date, time, and location, as well as contact information to ensure patient has resources to review if needed. Coordinate flow of information between medical clinic and patient insurance for referral authorization to secure a valid referral for clinic patient. Enter and annotate testing information and referrals, do e-referral for applicable practices for meaningful use and follow up to make sure e-referral or faxed referrals are received, document communications and action into PPMS and AEHR as appropriate. Job Requirements High School Graduate General Studies and 2 years of progressively responsible related experience in a healthcare environment, upon hire or High School GED General Studies and 2 years of progressively responsible related experience in a healthcare environment, upon hire. Preferred Qualifications 2 years of progressively responsible related experience in a healthcare office environment specializing in the referral process. Experience in AEHR and PPMS system. Where You'll Work CommonSpirit Medical Group (Mountain Management Services) is a leading provider of comprehensive office management services and affiliated physicians in Southeast Tennessee and North Georgia. Our award‑winning, faith‑based organization is dedicated to supporting the delivery of exceptional healthcare in the region. We are proud to be consistently recognized for excellence by organizations like U.S. News & World Report, PINC AI™, CMS, Healthgrades®, Leapfrog, and as one of the Best Places to Work in Tennessee. We are honored to be your trusted ally in health, dedicated to serving our community with compassion and excellence. Pay Range $16.83 - $23.77 /hour #J-18808-Ljbffr CHI

Vacancy posted 4 days ago
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