Referral and Prior Authorization Specialist

39 Paid Days Off Each Year

Position Summary

The Patient Referral Specialist is responsible for obtaining authorization and communicating with patients and providers about referrals generated by PrimeCare providers.

Duties and Responsibilities
Use the electronic medical record referral workqueue and referral reports to complete and obtain authorization of specialist referral orders, and imaging and procedure orders.
Prepare referral forms and transmit required information to specialists. Submit referral information to insurance companies for prior authorization.
Communicate with patients and providers to obtain any needed information for referral completion, and to inform of any unanticipated delays.
Identify in network providers for appropriate specialty and arrange appointments as necessary.
Document and inform patient of referral status. Communicate with patients and providers to obtain any needed information for referral completion. If needed, assist in scheduling appointments.
Conform with and abide by all regulations, policies, work practices and instructions.
Other duties and responsibilities as assigned.
Required Skills or Abilities Excellent written and verbal communication skills.
Strong computer skills with proficiencies in Outlook, Word, PowerPoint, Excel, internet-based applications, and the Microsoft operating system.
Ability to work effectively and independently.
Understanding and appreciation for diversity among patients and employees.
Excellent customer service skills.
Work in a team-oriented environment with a variety of professionals with different work styles and support needs.
Ability to see how one's work intersects with that of other departments of PrimeCare Community Health and those of partner organizations.
Bilingual in English and Spanish or Polish preferred.

Benefits
27 days of PTO each year, accrued each pay period
3 personal days
1 floating holiday
8 paid holidays
Medical/Dental/Vision coverage available the 1st of the month following 30 days
Company-paid life, short-term disability, and long-term disability coverage
Discretionary 403(b) match and profit sharing after meeting service requirements
Flexible spending accounts
Accident & critical illness coverage
Pet insurance

Salary

All wages are based on relevant years of experience. The minimum rate is the wage a candidate with no additional experience will earn.

PrimeCare Health is firmly committed to creating a diverse workplace and is proud to provide equal employment opportunities to all applicants. Therefore, PrimeCare does not discriminate on the basis of creed, color, national origin, sex, gender identity, sexual orientation, age, religion, marital or parental status, alienage, disability, political affiliation or belief, military or military discharge status. PrimeCare Community Health