Referral Specialist (Full-time, Days)

Summary

Referral Specialist is responsible for scheduling diagnostic testing and specialty referrals, obtaining insurance authorizations/pre-certifications, and coordinating with patients, physicians, facilities, and insurance companies. Provides excellent customer service and ensures accurate documentation in the EMR.

Job Title: Referral Specialist

Department: Heart Failure Office

Location: 1415 Portland Avenue- Medical Office Building

Suite 445

Hours Per Week: 40, Full-time

Schedule: Monday-Friday, 8am-4:30pm

Preferred Qualifications

• Associate degree in a related field.
• Medical terminology experience.
• Orthopedic terminology highly preferred.
• Experience with medical scheduling, insurance authorization, referrals, or EMR systems.

Required Qualifications

• High school diploma or GED.
• Proficiency with Microsoft Word, Excel, and computer systems.
• Strong organizational, communication, and customer service skills.
• Ability to multitask and work effectively in a fast-paced environment.
• Strong attention to detail and ability to maintain accurate records.

Responsibilities

• Schedule MRI, CT, Neurology, Pain Management, and other specialized testing and referrals.
• Obtain insurance authorizations and pre-certifications and submit required documentation.
• Verify procedure and diagnosis codes needed for authorization.
• Coordinate appointments, facility arrival times, and patient instructions.
• Communicate with patients, providers, facilities, and insurance companies.
• Document authorizations, communications, and scheduling information accurately in the EMR.
• Assist self-pay and out-of-network patients with appropriate resources.
• Support scheduling policies, procedures, and efficient practice operations.
• Perform other duties as assigned.

EDUCATION:

LICENSES / CERTIFICATIONS: 

PHYSICAL REQUIREMENTS:

For disease specific care programs refer to the program specific requirements of the department for further specifications on experience and educational expectations, including continuing education requirements.

Any physical requirements reported by a prospective employee and/or employee’s physician or delegate will be considered for accommodations.

PAY RANGE:

CITY:

POSTAL CODE:

The posted pay range is a good faith representation of potential base pay for this position. It may be modified in the future and eligible for additional pay components. Individual annual salaries/hourly rates could vary based on position details and FTE. Pay is determined by considering factors including, but not limited to, experience, relevant qualifications, specialty, internal equity, locations, and contracts.

Rochester Regional Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, predisposing genetic characteristics, marital or familial status, military or veteran status, citizenship or immigration status, or any other characteristic protected by federal, state, or local law.