Referral Specialist

The Referral and Authorization Specialist is responsible for ensuring patients have been cleared for specialty service office visits; obtaining and issuing referrals for ancillary, consult, radiology or lab visits; receiving approvals for medication formularies, durable medical equipment, home health care and other items or services as needed. Able to perform all duties of a Referral & Authorization Specialist I. In addition, schedules and coordinates tests and understands and communicates required preparation for tests. May act as escalation point for denials and other circumstances. May also enter charge entry data.

• Resolves, pre-certification, registration and case-related concerns prior to a patients appointment. This includes interacting with patients, insurance carriers and various internal departments
• Identifies appropriate formularies for patient medication management or vendors for durable medical equipment requests and receives insurance approvals for patients
• Completes the referral process for a patient's ancillary, consultation, radiology or lab visit. The process includes checking insurance coverage, sending approval and receiving confirmation, scheduling appointments and notifying patients of progress
• Provides backup support for medical practice duties as required

MINIMUM

• High School Diploma/G.E.D.
• Minimum of two (2) years experience in Medical Office or other healthcare environment
• Basic Computer skills
• Demonstrates excellent customer service skills
• Familiar with coding

PREFERRED

• Bilingual skills 
• Familiarity with the referral/authorization process and interacting with insurance carriers
• Detail oriented; comfortable working in high volume clinics

Hello humankindness Located conveniently in the heart of Phoenix, Arizona,St. Joseph's Hospital and Medical Center is a 571-bed, not-for-profit hospital that provides a wide range of health, social and support services. Founded in 1895 by the Sisters of Mercy, St. Joseph's was the first hospital in the Phoenix area. More than 125 years later, St. Joseph's remains dedicated to its mission of caring for the poor and underserved. We are extremely proud to be a nationally recognized center for quality quaternary care, medical education and research. St. Joseph's includes the internationally renowned Barrow Neurological Institute, Norton Thoracic Institute, Cancer Center at St. Joseph's, Ivy Brain Tumor Center, and St. Joseph's Level I Trauma Center (which is verified by the American College of Surgeons). The hospital is also a respected center for high-risk obstetrics, neuro-rehabilitation, orthopedics, and other medical services. St. Joseph’s is considered a sought-after destination hospital for treating the most complex cases from throughout the world. Every day, approximately 20 percent of the hospital’s patients have traveled from outside of Arizona and the United States to seek treatment at St. Joseph’s. U.S News & World Report routinely ranks St. Joseph's among the top hospitals in the United States for neurology and neurosurgery. In addition, St. Joseph's boasts the Creighton University School of Medicine at St. Joseph's, and a strategic alliance with Phoenix Children's Hospital. St. Joseph's is consistently named an outstanding place to work and one of Arizona's healthiest employers. Come grow your career with one of Arizona's Most Admired Companies. Look for us on Facebookand follow us on Twitter. For the health of our community ... we are proud to be a tobacco-free campus.