Healthcare Referral Navigator

Universal Health Services; McAllen (TX); On-site; USD 36,000 - 48,000; Full time

Job summary

South Texas Health System Clinics (IPM, a subsidiary of Universal Health Services) is seeking a Referral Specialist to coordinate patient referrals, obtain pre-authorizations, and communicate with clinics and hospitals. The role supports the mission and values of the practice while ensuring proper utilization of services.

You will review clinical data for medical necessity and collaborate with providers and staff to ensure timely scheduling and test coordination across our Rio Grande Valley

Qualifications

• High school diploma or GED required.
• Must maintain CPR certification.
• Minimum of two years of clinical experience required.
• Knowledge of administrative and clerical procedures and systems, and other office procedures and terminology.
• Knowledge of electronic equipment, computer hardware and software, including applications and programming.
• Knowledge of principles and processes for providing customers and personal services, including customer needs assessment and satisfaction.

Responsibilities

• Scheduling referrals for patients and providers, pre-authorizing and pre-certifying tests/procedures.
• Scheduling of other tests with facilities at the request of providers and/or staff.
• Direct communication with clinics, referred clinics, and patients.
• Reviewing clinical data to report medical necessity to insurance companies.

Skills

Clinical experience

Customer service

Administrative procedures

CPR certification

EMR experience

Office procedures

Communication skills

Education

High school diploma or GED

Tools

EMR systems

Office software

Computer hardware & software basics

Job description

South Texas Health System Clinics (IPM, a subsidiary of Universal Health Services) is seeking a Referral Specialist to coordinate patient referrals, obtain pre-authorizations, and communicate with clinics and hospitals. The role supports the mission and values of the practice while ensuring proper utilization of services.

You will review clinical data for medical necessity and collaborate with providers and staff to ensure timely scheduling and test coordination across our Rio Grande Valley