Referral Specialist

Responsibilities

This is a full-time, on-site position with working hours from approximately 8:00 AM to 5:00 PM, Monday through Friday, with no night or weekend shifts. The role will be based at our MPA - Women's Oncology practice, located at 3425 University Parkway, Suite 102, Sarasota, FL.

The Referral Specialist is responsible for scheduling referrals for patients and providers, as well as pre-authorizing and pre-certifying tests/procedures Scheduling of other tests with facilities at the request of providers and/or staff. Communicates effectively with patients, clinics, and hospitals. Reviews clinical data to report medical necessity to insurance companies. Performs all work with accord to the mission, vision, and values of the practice

Independence Physician Management (IPM), a subsidiary of UHS, was formed in 2012 as the physician services unit of UHS. IPM develops and manages multi-specialty physician networks and urgent care clinics which align with UHS acute care facilities. It also provides select services for the Behavioral Health division of UHS. Through continuing growth, IPM operates in 11 markets across six states and the District of Columbia.

Our leadership team, practitioners, and teams of healthcare professionals are collectively dedicated to improving the health and wellness of people in the communities we serve.

As a Manatee Physician Alliance employee you will be part of a first class organization offering:

• A Challenging and rewarding work environment
• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401(K) with company match

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $14.3 billion in 2023. During the year, UHS was again recognized as one of the World’s Most Admired Companies by Fortune;

and listed in Forbes ranking of America’s Largest Public Companies.

Headquartered in King of Prussia, PA, UHS has approximately 96,700 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington D.C., Puerto Rico and the United Kingdom.

Education
:
High school graduate or GED required.

Work experience
:

• Minimum of one-three years’ experience in a healthcare or clinical setting

Knowledge
:

• Knowledge of clinical terminology, insurance billing, procedural and diagnosis coding, federal and state insurance
• Knowledge of regulations and HIPAA privacy standards is strongly preferred.
• Typing, 10 key, and computer skills required.
• Proficiency in Microsoft Office applications required.
• Acute healthcare knowledge and ability to evaluate clinical data to acquire pre-authorizations and referrals is preferred. Knowledge of third‑party reimbursement regulations is preferred.
• Patient Management, Billing and Managed Care system processes competency.
• Understanding of functions and workflow of Clinical/Hospital departments

Skills
:

• Excellent organization skills, attention to detail, research, and problem-solving ability.
• Results oriented with a proven track record of accomplishing tasks within a high-performing team environment.
• Able to multi-task and meet established time frames.
• Required effective interpersonal skills and excellent written, oral communication skills required.
• Service-oriented/customer-centric.
• Strong teamwork skills
• S…