Referral and Authorization Specialist

Job Summary

To process referrals and prior authorizations, the full-time remote Referral and Authorization Specialist will manage timely communications between PCPs, specialists, and insurance companies while handling inbound calls from various stakeholders.

Key responsibilities

• Process referrals from PCPs to specialists, imaging, and procedures efficiently
• Obtain prior authorizations from insurance companies in accordance with payer guidelines
• Handle inbound calls from specialists, patients, and insurance companies regarding referrals and authorizations

Required qualifications

• Experience in processing referrals and prior authorizations
• Knowledge of insurance payer guidelines and standards
• Proficiency in handling inbound calls related to healthcare services
• Ability to work independently in a remote environment
• Strong organizational skills to manage multiple tasks effectively