Referral Authorization Specialist

Job Summary

A company is looking for a Referral Authorization Specialist to coordinate prior authorizations and manage referrals in a healthcare setting.

Key Responsibilities

• Obtain prior authorizations and manage outgoing referrals to ensure compliance with payer requirements
• Serve as a liaison between providers, patients, and payers to reduce denials and delays in care
• Monitor authorization and referral workqueues for timely completion and assist with denial prevention

Required Qualifications

• High school diploma or equivalent required; Associate degree preferred
• Minimum of two years of experience in healthcare referrals, prior authorizations, or revenue cycle
• Experience with Medicare, Medicaid, and commercial payers preferred
• Strong knowledge of insurance plans and authorization requirements
• Familiarity with EMR systems and medical terminology