Care Access & Referral Specialist

CommonSpirit Health; Federal Way (WA); On-site; USD 25,000 - 39,000; Full time

Job summary

Virginia Mason Franciscan Health is seeking a Referral Specialist to orchestrate patient access to specialized care by managing referral and authorization processes. You will obtain clearances for specialty visits, issue referrals for ancillary services, and secure approvals for medications, DME, home health, and other services, ensuring accurate records and compliant workflows.

Ideal candidates demonstrate meticulous attention to detail, strong organizational skills, and clear communication to

Qualifications

• Accredited medical terminology course or equivalent on-the-job training.
• At least one year of progressively responsible work experience relevant to the role.
• None, upon hire

Responsibilities

• Processes referral orders and/or pre-authorizations.
• Ensures insurance eligibility checks are conducted on all referrals before the patient is seen.
• Completes referrals/pre-authorizations for diagnostic testing, therapy, surgeries and specialty care.
• Provides information to patients regarding their health care plan and explains benefits.
• Notifies physicians and patients when referral is denied or additional info is needed.
• Updates patient records in the electronic medical record.
• Coordinates patient appointments and ancillary services.
• Responds to routine billing and insurance questions.
• Coordinates patient instructional/educational activities regarding the referral.
• Coordinates purchase of materials or rental of medical equipment.

Education

Medical Terminology course

Job description

Virginia Mason Franciscan Health is seeking a Referral Specialist to orchestrate patient access to specialized care by managing referral and authorization processes. You will obtain clearances for specialty visits, issue referrals for ancillary services, and secure approvals for medications, DME, home health, and other services, ensuring accurate records and compliant workflows.

Ideal candidates demonstrate meticulous attention to detail, strong organizational skills, and clear communication to