Referral Specialist Full-Time

Referral Authorization Specialist

We are seeking a skilled Referral Authorization Specialist to support patient care at Up Health System – Portage.

Responsibilities

Completes pre-authorizations for all diagnostic testing, therapy, surgical and specialty care appointments according to insurance requirements within 3 days of issuance.

Notifies patient when referral is approved and communicates with provider if denied or if additional information is required.

Documents all communication with patient, nurse, and provider in the clinic EMR.

Updates referrals in the EMR each time communication occurs with patient, insurance provider, nurse, or provider.

Maintains up-to-date knowledge of all health care plans and interprets and communicates plan policies and procedures to employees, physicians, and patients when they change.

Identifies and attempts to resolve patient barriers to specialty care, including scheduling appointments and coordinating with specialist offices.

Tracks high-priority referrals to ensure high‑risk patients receive necessary follow‑up care.

Under supervision of a physician or nurse, assists with performing patient assessments and treatments.

Performs administrative or clerical duties as assigned, including filing, reception, scheduling, data entry, and patient registration.

Qualifications

High school diploma required; associate’s degree preferred.

Minimum 1 year experience in a medical office setting preferred.

Critical thinking skills, decisive judgment, ability to work with minimal supervision, thrive under stress, and take appropriate action.

Benefits

Comprehensive benefits: multiple levels of medical, dental, and vision coverage for full‑time and part‑time employees.

Financial protection and PTO: life, accident, critical illness, hospital indemnity insurance, short‑ and long‑term disability, paid family leave, and paid time off.

Financial & career growth: higher education and certification tuition assistance, loan assistance, 401(k) retirement package with company match.

Employee well‑being: mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services, and discount programs).

Professional development: ongoing learning and career advancement opportunities.

EEOC Statement

UP Health System – Portage is an Equal Opportunity Employer. We are committed to Equal Employment Opportunity for all applicants and employees and comply with all applicable laws prohibiting discrimination and harassment in employment.

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