Join our team as a Referral & Authorization Specialist, supporting radiology, imaging, physical therapy (PT) referrals, and prior authorizations. This role provides a fantastic opportunity to deepen your expertise in managing referrals and authorizations, working with a dedicated team in a hybrid setup. After your initial training period onsite, you'll transition to a fully remote position, supporting the team from anywhere!
What You'll Do:
Access and sort work queues daily in EPIC and manage your assigned daily appointment reports.
Initiate and follow up on prior authorizations, ensuring all requests are processed accurately and efficiently.
Manage incoming inquiries and outside referral requests, providing clear and professional responses.
Support team workload distribution, taking on additional queues as needed to maintain balance and team efficiency.
Achieve Key Performance Indicators (KPIs) by completing 15-30 authorizations per day, with a target of 30 once fully trained (adjusted based on complexity of services).
Must-Have Skills & Qualifications:
Referral Management Experience: Ideally 2+ years in initiating, tracking, and completing referrals.
Portal Experience: Proficiency with OneHealth Port and AIM Portal (2-3+ years).
Strong Insurance Knowledge: In-depth understanding of insurance terminology and payer processes.
Nice-to-Have Skills:
Familiarity with EPIC for managing workflows.
Key Soft Skills & Attributes:
Adaptability: Able to adjust to evolving services or priorities.
Quick Learning Ability: Fast-paced learners who can quickly familiarize themselves with new systems.
Strong Communication: Excellent verbal and written communication skills to liaise effectively with supervisors, leads, and stakeholders.
Critical Thinking & Analytical Skills: Ability to analyze workflows and optimize processes.
Time Management: Capable of meeting deadlines while managing a high volume of referrals.
Proactive Follow-Up: Committed to following up on tasks and inquiries within a 24-48 hour timeframe.
Schedule & Shift:
Monday - Friday, 7:30 AM - 4:00 PM
Hybrid Schedule: Onsite training required initially (2-4 weeks depending on experience); transition to fully remote after training.
Why Join Us?
Hybrid Flexibility: Transition to remote work after initial training.
Collaborative Environment: Work with a supportive, team-focused group that values adaptability and a strong work ethic.
Career Growth: Opportunity to build your expertise in referrals and authorizations with a clear path for growth.