Care Referral & Authorization Specialist

CommonSpirit Health; Ringgold (GA); On-site; USD 42,000 - 54,000; Full time

Job summary

CommonSpirit Medical Group in Ringgold, GA is seeking a Referral Specialist to orchestrate patient access by managing referrals and authorizations for specialty care. You will obtain clearances for visits, issue referrals for ancillary services, and secure approvals for medications and related services.

Strong attention to detail and clear communication are essential to ensure smooth patient flow. You will verify orders, answer billing questions, coordinate appointments, and ensure accurate

Qualifications

• High school diploma or GED with healthcare experience.
• Experience in a healthcare environment and referral processes preferred.
• Experience with AEHR and PPMS systems is a plus.

Responsibilities

• Gather, verify, and process referrals, authorizations, and pre-certifications with physicians, patients, and payers.
• Communicate plan details and billing/insurance questions to patients clearly.
• Set up appointments, coordinate clinic visits, and arrange transport or interpreters as needed.
• Provide patients with referral information including date, time, location, and contact details.
• Coordinate sharing of information between clinic and patient insurance for valid referrals.
• Enter and annotate testing information and referrals, perform e-referrals as applicable, and document communications in PPMS/AEHR.

Skills

Attention to detail

Organizational skills

Clear communication

Education

High School Diploma

GED

Tools

AEHR

PPMS

Job description

CommonSpirit Medical Group in Ringgold, GA is seeking a Referral Specialist to orchestrate patient access by managing referrals and authorizations for specialty care. You will obtain clearances for visits, issue referrals for ancillary services, and secure approvals for medications and related services.

Strong attention to detail and clear communication are essential to ensure smooth patient flow. You will verify orders, answer billing questions, coordinate appointments, and ensure accurate