Referral Specialist (Full-time, Days)

Summary

The Authorization & Scheduling Coordinator is responsible for scheduling and obtaining insurance authorizations/pre-certifications for MRI, CT, Neurology, Pain Management, and other specialized testing, as well as referrals to physician specialists. This role ensures all patient and third-party interactions are accurately documented in the electronic medical record (EMR) system while promoting excellent customer service and appropriate patient care coordination.

Responsibilities

• Greet and assist patients in person and over the phone with a positive and helpful attitude

• Coordinate diagnostic testing and referrals between physicians, patients, facilities, and insurance payers

• Review medical documentation for accuracy and completeness prior to scheduling and authorization

• Obtain procedure and diagnosis codes necessary for insurance authorization and pre-certification

• Complete insurance authorization/pre-certification requests and submit required supporting documentation

• Document authorization details, including approval information and insurance contact details, within the EMR

• Notify patients of scheduled appointments, procedures, preparation instructions, and arrival times

• Coordinate scheduling details with hospitals and testing facilities

• Assist with reviewing and updating scheduling-related policies and procedures

• Maintain working knowledge of office equipment including telephones, computers, printers, copiers, and fax machines

• Support operational efficiency by performing additional administrative duties as needed

• Ensure patient interactions are age-appropriate and culturally sensitive

Required Qualifications

• High school diploma or GED required

Preferred Qualifications

• Associate degree (AAS) in a related field preferred

• Previous medical office or healthcare scheduling experience preferred

• Proficiency in Microsoft Word and Excel

• Familiarity with EMR systems and healthcare documentation practices preferred

• Orthopedic terminology highly preferred

• Experience obtaining insurance authorizations and pre-certifications preferred

EDUCATION:

LICENSES / CERTIFICATIONS: 

PHYSICAL REQUIREMENTS:

S - Sedentary Work - Exerting up to 10 pounds of force occasionally Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

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:

$19.00 - $24.00Rochester14621

The listed base pay range is a good faith representation of current potential base pay for a successful full time applicant. It may be modified in the future and eligible for additional pay components. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, 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.