Referral Specialist II

Referral Specialist II

Location: West Salem Clinic | 1233 Edgewater St NW, Salem, OR Schedule: Full Time | MondayFriday Status: Non-Exempt Reports to: Patient Access Team Supervisor

Make a Difference in the Patient Journey

At Northwest Human Services (NWHS), we believe access to quality healthcare should never be a barrier to living a healthy life. As a nonprofit Federally Qualified Health Center, we are committed to providing compassionate, equitable, and affordable healthcare and social services to individuals and families throughout Marion and Polk counties.

We are looking for a detail-oriented and patient-focused Referral Specialist II who is passionate about helping patients navigate the healthcare system. In this role, you will play an essential part in coordinating specialty care, obtaining insurance authorizations, and ensuring patients receive timely access to the services they need.

As a Referral Specialist II, you will help bridge the gap between primary care providers, patients, specialists, and insurance companies to ensure a smooth and timely referral process.

What You'll Do

• Coordinate Patient Referrals: Monitor daily referral requests, facilitate specialty appointments, and ensure referrals are processed accurately and within established timelines.
• Navigate Insurance Requirements: Obtain pre-authorizations for specialty services, procedures, and medications through insurance companies, HMOs, and other third-party payers.
• Support Patients: Respond to patient questions, explain referral processes, coordinate appointments and interpreter services, and help resolve barriers to accessing care.
• Collaborate Across Care Teams: Communicate with providers, specialists, and insurance representatives to coordinate services and keep the referral process moving forward.
• Maintain Accurate Documentation: Track referrals, document authorization activity, and ensure consultation reports are received and recorded in patient medical records.

What Makes You Successful

Patient-Centered Service: Treats patients with compassion, patience, and respect while providing clear, helpful communication.

Attention to Detail: Accurately manages referral documentation, insurance authorizations, and follow-up activities while meeting deadlines.

Problem-Solving: Takes initiative to identify barriers, resolve referral issues, and coordinate solutions among patients, providers, specialists, and insurance companies.

Communication & Collaboration: Communicates effectively in person and by phone while building positive working relationships across departments.

Accountability & Initiative: Works independently, exercises sound judgment, follows established procedures, and takes ownership of assigned responsibilities.

What You'll Bring

Required Qualifications:

• High school diploma or equivalent.
• Proficiency in medical terminology.
• Current working knowledge of health insurance coverage, referral procedures, and pre-authorization requirements.
• Ability to communicate effectively and professionally with patients, providers, insurance representatives, and the public.
• Ability to manage multiple priorities, meet deadlines, and maintain accuracy in a fast-paced healthcare environment.

SUMMARY OF BENEFITS: Our Agency strives to provide a benefits program that is comprehensive and competitive within our industry.

• Healthcare insurance plans: Medical, Dental, Vision
• Group Life: Short-Term & Long-Term Disability 100% paid by employer
• 403(b) retirement plan with 2% of employer contribution and up to 3% employer match
• Flex Spending Account
• PTO - 10 hours a month for FT positions 40 hrs./wk. up to 20 hours monthly as your tenure grows
• 7 Paid Holidays a year + 2 paid floating holidays for full-time positions
• Continuing Education & Training Benefits
• Employee Healthy Living Program Gym Membership & Smoking Cessation

Why NWHS?

At NWHS, you are more than an employee; you are part of a mission-driven team working to strengthen the health and well-being of our community.

Join our team and help make a difference in the lives of the people and communities we serve.