On-Site Referral & Authorization Specialist

Frederick Health; Frederick (MD); On-site; USD 24,000 - 31,000; Full time

Benefits offered by this job

Health, Dental & Vision insurance

403(b) retirement plan with company匹配

Paid Time Off

Educational assistance program

Employee Assistance Program

Job summary

Frederick Health is seeking a Referral Authorization Specialist to support patient access and revenue cycle operations on-site in Frederick, MD. You will verify insurance eligibility, secure authorizations and pre-determinations, and provide accurate price estimates in compliance with the No Surprises Act.

You will collaborate with clinical staff and insurers, manage referrals, and deliver premier customer service to internal and external customers while upholding FH compliance standards.

Qualifications

• High school diploma or GED required; healthcare coursework preferred.
• Experience in revenue cycle billing or insurance authorizations is a plus.
• Familiarity with insurance requirements, CPT/ICD-10 codes, and eligibility checks.

Responsibilities

• Complete pre-determination and authorization processes before services.
• Verify patient demographics and insurance details for accuracy.
• Provide referrals and pricing estimations per payer guidelines.
• Handle insurance authorizations and predeterminations with customer service focus.
• Escalate as needed for peer-to-peer reviews and compliance.

Skills

Attention to detail

Time management

Customer service

Communication skills

HIPAA compliance

Problem solving

Education

High school diploma or GED

Some college coursework preferred

Tools

NextGen

Meditech

Microsoft Excel

Microsoft Word

Microsoft Outlook

Job description

Frederick Health is seeking a Referral Authorization Specialist to support patient access and revenue cycle operations on-site in Frederick, MD. You will verify insurance eligibility, secure authorizations and pre-determinations, and provide accurate price estimates in compliance with the No Surprises Act.

You will collaborate with clinical staff and insurers, manage referrals, and deliver premier customer service to internal and external customers while upholding FH compliance standards.