Overview:

Join our team as a Referral & Authorization Specialist , supporting radiology, imaging, physical therapy (PT) referrals, and prior authorizations. This role provides a fantastic opportunity to deepen your expertise in managing referrals and authorizations, working with a dedicated team in a hybrid setup. After your initial training period onsite, you'll transition to a fully remote position, supporting the team from anywhere!

What You’ll Do:

• Access and sort work queues daily in EPIC and manage your assigned daily appointment reports.
• Initiate and follow up on prior authorizations, ensuring all requests are processed accurately and efficiently.
• Manage incoming inquiries and outside referral requests, providing clear and professional responses.
• Support team workload distribution, taking on additional queues as needed to maintain balance and team efficiency.
• Achieve Key Performance Indicators (KPIs) by completing 15-30 authorizations per day, with a target of 30 once fully trained (adjusted based on complexity of services).

Must-Have Skills & Qualifications:

• Referral Management Experience : Ideally 2+ years in initiating, tracking, and completing referrals.
• Portal Experience : Proficiency with OneHealth Port and AIM Portal (2-3+ years).
• Strong Insurance Knowledge : In-depth understanding of insurance terminology and payer processes.

Nice-to-Have Skills:

• Familiarity with EPIC for managing workflows.

Key Soft Skills & Attributes:

• Adaptability : Able to adjust to evolving services or priorities.
• Quick Learning Ability : Fast-paced learners who can quickly familiarize themselves with new systems.
• Strong Communication : Excellent verbal and written communication skills to liaise effectively with supervisors, leads, and stakeholders.
• Critical Thinking & Analytical Skills : Ability to analyze workflows and optimize processes.
• Time Management : Capable of meeting deadlines while managing a high volume of referrals.
• Proactive Follow-Up : Committed to following up on tasks and inquiries within a 24-48 hour timeframe.

Schedule & Shift:

• Monday - Friday, 7:30 AM - 4:00 PM
• Hybrid Schedule : Onsite training required initially (2-4 weeks depending on experience); transition to fully remote after training.

Why Join Us?

• Hybrid Flexibility : Transition to remote work after initial training.
• Collaborative Environment : Work with a supportive, team-focused group that values adaptability and a strong work ethic.
• Career Growth : Opportunity to build your expertise in referrals and authorizations with a clear path for growth.