Authorization & Referrals Specialist

Job Summary:

The Authorization/Referral Specialist is responsible for obtaining preauthorization for patient testing, medications, and other items as requested by providers and for processing referrals including obtaining appointments for patients. The Authorization/Referral Specialist is also responsible for assisting with other clerical responsibilities in the clinic(s). Additionally, he/she is responsible for functioning well as a member of the multidisciplinary team.  

Supervisory Responsibilities:

No Supervisory Responsibilities

Work Environment:

The work environment characteristics described are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Works inside under normal temperature conditions with adequate light, in a well-ventilated, clean area; some areas are limited in space; usually works around others; must expect some moderate noise.

1. No unusual hazard risks; may be exposed to muscular strain in supporting, lifting, and assisting patients.
2. Conditions of work may involve exposure to communicable diseases and on-the-job injuries.

This position has an OSHA Category I level of exposure to blood and body substances. Category I tasks are all procedures or other job-related tasks involving an inherent potential for mucous membrane or skin contact with blood, body fluids or body tissues or a potential for spills or splashes with blood, body fluids or tissues. Use of appropriate protective measures is required for every employee engaged in Category I tasks.

Duties/Responsibilities:

• Ensures all applicable regulatory requirements and governing practices are followed.  
• Promptly attends work as scheduled and completes position responsibilities by following established guidelines & protocols within the appropriate time frame.
• Works cooperatively and respectfully with other personnel, showing a spirit of teamwork and cooperation. Willingness to assist other clinics as needed.  
• Maintains confidentiality of the patient’s medical condition, personal problems, and medical record.  
• Shows initiative in completing job responsibilities.
• Is neat, clean, and dressed according to the Dress Code Policy.
• Demonstrates good skills in all forms of communication.
• Assist the CSR’s with the check in and check out process when necessary.
• Performs other related duties as assigned, ie: scanning documents into patient charts, appointment reminder calls etc, 

Required Skills/Abilities: 

• Basic computer skills required.
• Interpersonal skills- including customer relations, grammar, reading, and organizational skills.
• Must have excellent telephone etiquette and an outgoing personality.
• Must have the ability to work accurately and efficiently while under pressure.

Education and Experience:

• High school diploma or equivalent. A two-year associate degree in medical office administration or work in the medical field is preferred.  
• 1 year of Auth/Referral experience preferred.
• BLS certification required.  

Physical Requirements: 

Must be able to walk, stand, stoop, lift, balance, sit, kneel, hear, reach, pull, talk, see, turn, carry, push, handle and write. This job requires you to reach above the head, push/pull 5 lbs, lift/carry up to 15 lbs, and lift from floor to waist level.