HOURS: 11:00am-8:00pm M - F or 12:00pm-9:00pm M-F. Occasional weekends and overtime as needed.

The Referral Specialist I is responsible for providing support to a clinical team in order to facilitate the administrative components of clinical referrals.  

Primary duties may include, but are not limited to:

• Initiates and manages clinical referrals for pre-authorization.
• Acts as a liaison between hospital, health plans, physicians, patients, vendors and other referral sources.
• Reviews referrals for completeness and follows up for additional information if necessary.
• Assigns escalated referrals to staff as appropriate.
• Verifies insurance coverage and completes pre-authorization process for radiology and other imaging exams (CT, MRI, MRA, PET, et.) following established process and procedures.
• Responds to inbound calls initiating exam requests following established processes, meets quality and production standards.
• Contacts physician offices as needed to obtain demographic information or related data.
• Enters referrals, documents communications and actions in system.

Minimum qualifications:

• Requires HS diploma or GED and a minimum of 1 year of experience in a high-volume, interactive customer service or call center environment; or any combination of education and experience which would provide an equivalent background.

Preferred skills, qualifications and knowledge:

•  Knowledge of medical terminology preferred.
• Experience working as Pharmacy Tech highly preferred.
• Ability to type 45 WPM