Referral Specialist - Physician Practice - Supplemental
Listed on 2026-01-23
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Healthcare
Healthcare Nursing, Healthcare Administration
Qualifications
Required:
To perform this job successfully, an individual must be able to perform each essential job function satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
TYPICAL PHYSICAL/MENTAL DEMANDS:
While performing the duties of this job, the employee is required to sit or stand, walk, and reach. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, ability to adjust focus, and view a computer monitor throughout the shift. The employee must be clear-thinking and able to focus on work tasks amidst open office distractions and competing priorities.
Job Functions
- Is consistently at work and on time, as established.
- Prioritizes referrals by urgency and addresses them in a timely manner. Uses time efficiently.
- Ensures complete demographic, insurance information and appropriate/pertaining clinical information is sent to referred servicing providers.
- Contacts insurance companies to ensure prior authorization requirements are met. Presents necessary medical information to insurance companies to prove medical necessity of request.
- Researches and locates out-of-area specialists as needed for referrals.
- Able to work additional hours when necessary to reach goals.
- Communications - Speaks clearly and professionally in positive or negative situations; listens and gets clarification; responds well to questions and feedback; participates in meetings; edits work for spelling and grammar; keeps others adequately informed; selects and uses appropriate communication methods.
- Keeps abreast of current developments; requires minimal supervision; displays understanding of how job relates to others; maintains confidentiality per policy and regulations.
- Fluent in Word, Excel, and Outlook as well as job-related software and computers; uses available resources effectively; adapts to new technologies; keeps technical skills up to date.
- Demonstrates competence in relation to the defined mission, vision, values, and strategic plan of the organization. Apparent by ongoing completion of any or all of the following: proficiency testing, skill demonstration, practice of core standards for service excellence, and documentation review.
- Performs other duties as assigned.
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