Referral Specialist

Job Summary

The Referral Specialist is responsible for scheduling referrals for patients and providers, pre‑authorizing and pre‑certifying tests/procedures, scheduling other tests, communicating effectively with patients, clinics, and hospitals, and reviewing clinical data for insurance reporting.

• Schedules tests and referral appointments within 24 hours from receiving the physician order.
• Notifies patients within 24 hours of their appointment.
• Pre‑certifies appropriate tests with insurance companies within 48 hours of physician order.
• Communicates pre‑certification results to the patient and/or office in a timely manner.
• Communicates effectively with patients, clinics, and hospitals; addresses patients politely, promptly, and helpfully.
• Answers the phone within four rings in a courteous manner, identifying self and department.
• Demonstrates knowledge and skill in operating EMR software efficiently and effectively; uses referral tool and follows computer downtime procedures.
• Maintains a clean and orderly office and waiting area; orders supplies within budgetary guidelines.
• Returns all emails within 48 hours.
• Other duties as assigned.

• Retention Bonus Program (if offered).
• Loan Forgiveness Program (if offered).
• Competitive compensation and generous paid time off.
• Excellent medical, dental, vision and prescription drug plans.
• 401(k) with company match and discounted stock plan.
• SoFi student loan refinancing program.
• Career development opportunities within UHS and its 300+ subsidiaries.

• High school graduate or GED required.
• Minimum of 1‑3 years of experience in a healthcare or clinical setting.
• Knowledge of clinical terminology, insurance billing, procedural and diagnosis coding, and federal and state insurance regulations.
• Knowledge of HIPAA privacy standards preferred.
• Typing, 10‑key, and computer skills required.
• Proficiency in Microsoft Office applications required.
• Acute healthcare knowledge and ability to evaluate clinical data for pre‑authorizations and referrals preferred.
• Knowledge of third‑party reimbursement regulations preferred.
• Patient management, billing, and managed care system process competency.
• Understanding of clinical/hospital department functions and workflow.

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and support recruitment, selection, placement, promotion, and compensation of individuals without regard to race, color, religion, age, sex, gender identity, sexual orientation, genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state, or local laws.