Referral Specialist
Posted 1 month ago Expired
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Upload Your ResumeAbout This Role
The Referral Specialist supports a positive patient experience by efficiently processing requests for referrals, prior authorizations, and diagnostic imaging. This role ensures high-quality, compassionate healthcare for families in the community.
Responsibilities
- Facilitate outgoing referral requests, including obtaining prior authorization when necessary
- Obtain prior authorization for patient medications
- Schedule and obtain prior authorization for diagnostic imaging requests
- Meet position requirements and perform essential functions
- Complete all mandatory training as required
Requirements
- High school diploma or equivalent
- 1-2 years of credentialing experience
- Knowledge of credentialing processes, insurance payers, and regulatory standards (CAQH, Medicare, Medicaid)
- Strong organizational skills with high attention to detail
- Excellent written and verbal communication skills
- Proficiency with credentialing software, Microsoft Office (Word, Excel, Outlook), and practice management systems
- Ability to work independently and manage multiple deadlines simultaneously
Qualifications
- High school diploma or equivalent required; associate or bachelor's degree preferred
- Minimum 1-2 years of credentialing experience, preferably in a pediatric or outpatient healthcare setting
Nice to Have
- Associate or bachelor's degree
- Experience in a pediatric or outpatient healthcare setting
Skills
* Required skills
Benefits
About SouthernMED Pediatrics
SouthernMED Pediatrics provides high quality, compassionate health care to families in their communities, treating each child as their own. Their staff and providers strive to make each encounter pleasant and informative while respecting the time and individual needs of patients and families.