Referral Specialist - Pediatrics

Referral Specialist – Pediatrics Job Summary

• Occupation:
  Referral Specialist
• Specialty:
  Pediatrics
• Salary: $22.44–$35.90/hour
• Working Hours:
  
  40 hours/week
• Shifts:
  
  Day
• On-Call:
  No
• Degree
  
  Required:
  
  High school diploma or equivalent
• Position Type:
  Full Time
• Work Environment:
  Hospital Clinic
• Location:
  
  93555, Ridgecrest, California, United States
• Visa Sponsorship:
  No

We’re looking for a Referral Specialist to support the RRH Pediatrics Department with managing referrals and prior authorization requests. In this role, you’ll help ensure timely, accurate processing of pediatric patient referrals, assist in navigating insurance requirements, and support families and clinical teams throughout the referral process.

This position is ideal for someone who thrives in a fast-paced environment, excels in customer service, and is confident in handling insurance documentation and communication. If you're detail-oriented, proactive, and enjoy supporting both patients and providers, this could be the right fit for you.

• Receive, process, and document referrals and prior authorization requests
• Obtain and verify insurance pre-authorizations and re-authorizations
• Maintain compliance with documentation standards and insurance requirements
• Collaborate with pediatric clinical teams and Patient Financial Services to support the referral workflow
• Communicate with patients, families, providers, and insurance companies
• Track and adapt to ongoing insurance and referral policy changes
• Support the overall improvement of referral processes and customer service

This role involves working closely with our pediatric and administrative teams to ensure timely patient referrals and contribute to a supportive and collaborative work environment.

• High school diploma or equivalent required
• Two years of college in a related field or business school preferred
• Medical Assistant, LVN, or RN background highly desired
• Minimum of three years’ experience in medical insurance or related field
• Familiarity with prior authorization and referral processes for diagnostics, therapies, and procedures
• Computer proficiency (Microsoft Word, Excel)
• Typing speed of 25 WPM without errors
• Excellent communication skills in English
• Demonstrated commitment to Service Excellence

• Dental
• Vision and 403B
• Life Insurance
• Flex Spending Accounts
• AFLAC Supplemental Plans
• Employee Assistance Program
• Gym Membership Reimbursement
• Tuition Reimbursement
• Paid Time Off

Established for 60 years, RRH is a non-profit, full-service Hospital with 25 inpatient beds, a 99-bed skilled nursing facility, clinics, and other outpatient services. RRH has state-of-the-art facilities and offers multi-specialty healthcare, view Treatment & Care. In 2023, it was honored by the American Medical Association for promoting the well-being of healthcare workers and has an established physician well-being program.

Our mission is to be the partner of choice for the healthcare needs of our community. Our purpose is to care for our community’s health and the well-being of those who care for them.

Ridgecrest is a family-friendly community of 30,000 in the desert of central Southern California, far from the traffic and commotion of LA. Affordable and safe, it’s been voted as the best place to live in Kern County by Niche. Home of the China Lake Naval Air Weapons Station, it is near the Sierra Mountains and full of natural wonders, outdoor activities, and sunshine.

Our hospital is close to Mammoth Ski Area, Mount Whitney, Sequoia National Forest and Death Valley. Learn more About Ridgecrest and the Outdoor Activities around it.