Physician Authorization/Referral Specialist I

Join our team as a Physician Authorization/Referral Specialist, where you'll play a vital role in ensuring patients receive timely, coordinated care.
The Specialist is responsible for obtaining and processing elective, urgent, and emergent referrals and authorizations for a wide range of outpatient services, including cardiology, audiology, lab testing, genetic testing, and certain medications. They verify insurance eligibility and benefits, calculate and communicate patient cost estimates, and ensure copay requirements and approvals are completed before services occur.
This role works closely with insurance companies, primary care providers, partner hospitals, and internal departments to ensure accurate information, timely claim processing, and seamless patient support. The Specialist uses daily reports and work queues to follow up on pending cases, participates in department huddles, and helps resolve issues that could affect reimbursement. They are also expecte...

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