Job Description Summary

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Patient Authorizations and Referral Specialist manage daily inbound calls related to prior authorizations, guiding callers through submission processes, updates, and approvals in alignment with department guidelines. They collaborate with clinical teams, production RSAs, and internal departments to resolve inquiries efficiently while delivering a high-quality customer experience.

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How will you make an impact & Requirements

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How will you make an impact & Requirements

Phone Team RSA’s (Referral Services Assistant) handle daily inbound calls related to prior authorization requests. Their core responsibilities include:

• Guiding callers through the process of submitting authorization requests

• Assisting with modifications or cancellations of existing authorizations

• Communicating the status of authorization requests clearly and efficiently

• Approving eligible authorizations in accordance with departmental guidelines

Phone Team RSAs collaborate closely with:

• Production RSAs

• Clinical teams including RNs and MD reviewers

• Internal support departments

• This cross-functional teamwork ensures timely and accurate resolution of provider inquiries while maintaining a high standard of customer service.

Skills & Experience

• Proven experience in a Call Center environment

• Solid understanding of medical terminology

• Background in the healthcare industry is essential

• Prior Utilization Management (UM) experience is strongly preferred

• Strong proficiency in navigating multiple systems and databases

• Analytical mindset with strong problem-solving abilities

• Ability to stay calm and professional in high-pressure situations

• Demonstrates initiative, independence, and ownership in day-to-day tasks

Shift: Monday-Friday 8 AM-5 PM Pacific Standard Time

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Compensation:

$17.10

to

$29.70