Medical Referral Specialist

Description

This position is a full-time Referral Specialist role located within our Johns Creek location.

Duties include:

• Processing incoming and outgoing calls to secure referrals and authorizations from providers and insurance companies
• Perform online authorizations of services
• Provide support to providers regarding utilization and authorization of referrals
• Contact providers with authorization, denial, and appeals process information as necessary
• Generate specialty referrals for members as requested by primary care physicians
• Assuring all pertinent documentation is forwarded to the provider
• Develop and maintain excellent record keeping systems

Requirements

The Job requirements are as follows:

• Must be able to execute above job description
• 2+ yrs work experience in healthcare referral & referral tracking preferred
• High school diploma or equivalent
• Must have an understanding of pediatric healthcare ICD10 and CPT codes
• Detail oriented and organized
• Critical decision making and problem solving skills

Shift: Monday-Friday, 8:00am-5:00pm with 1-hr lunch

Benefits include Medical, Dental, Vision, 401k Match, Medical & Dependent Care FSA, STD, and annual uniform allowance.