Prior Authorization/Referral Representative

The Prior Authorization/ Referral specialist is responsible for completing insurance referrals and authorizations.

This position communicates constantly with the Patient access manager (position supervisor) and provides the highest level of customer service to our patients, visitors, and coworkers.

Expectation:

• Completes insurance authorizations and referrals to meet the needs of the internal medicine team.
• Properly documents efforts to obtain auths/referrals.
• Effectively communicates with team members and patients the status of tasks.
• Identifies operational issues and works with manager to resolve.
• Maintains strictest confidentiality.
• Performs other tasks as needed as assigned by operational leadership.
• Assists with covering for department during vacations or illness of other personnel.
• Special projects as assigned by supervisor.

Qualifications:

Required skills & qualifications:

• Professional, calm demeanor and professional, positive attitude
• Effective communication and customer service skills
• Excellent follow through and logical problem-solving abilities
• Demonstrates responsibility and initiative
• Ability to handle a stressful environment and multi-task in a fast-paced environment
• Strong attention to detail
• Excellent computer skills
• Six (6) months administrative, secretarial or related office experience required, preferably in the medical field.
• At least one (1) year of customer service (any field)
• Medical insurance knowledge required.
• Word processing and computer experience required.

Preferred skills & qualifications:

• Knowledge of EMR systems
• Understanding of medical terminology
• Experience in a medical clinic
• Experience in authorizations

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Weekly day range:

• Monday to Friday

Work Location: In person