Pediatric Referral Specialist — Streamline Authorizations

SouthernMED; Lexington, Northern (SC, KY); Hybrid; USD 22,000 - 36,000; Full time

Benefits offered by this job

Paid Time Off

Matching 401K

Annual Merit Increases

Mental Health and Counseling Programs

Dental and Orthodontic Coverage

Vision Insurance

Health Care with Low Premiums

Short-term Disability

Access to Virtual Health & Wellness

Job summary

SouthernMED seeks a Referral Specialist to support pediatric outpatient referrals and prior authorizations in Lexington, SC. You will coordinate requests for imaging and medications, ensuring timely approvals and accurate documentation.

Ideal candidates bring 1–2 years in credentialing, strong communication, and proficiency with Office tools and credentialing software. Join a team dedicated to compassionate family care and efficient patient experiences.

Qualifications

• High school diploma or equivalent required.
• 1-2 years credentialing experience, pediatric/outpatient preferred.
• Knowledge of CAQH, Medicare, and Medicaid regulatory standards.
• Strong organizational skills and attention to detail.
• Excellent written and verbal communication.

Responsibilities

• Facilitates outgoing referral requests including obtaining prior authorization when necessary.
• Obtains prior authorization for patient medications.
• Schedules and obtains prior authorization for diagnostic imaging requests.
• Meets position requirements and performs essential functions.
• Completes all mandatory training as required.
• Performs other duties as assigned.

Skills

Strong organizational skills

Excellent written and verbal沟

Education

High school diploma or equivalent

Associate or Bachelor's degree preferred

Tools

Microsoft Word

Microsoft Excel

Microsoft Outlook

Credentialing software

Practice management systems

Job description

SouthernMED seeks a Referral Specialist to support pediatric outpatient referrals and prior authorizations in Lexington, SC. You will coordinate requests for imaging and medications, ensuring timely approvals and accurate documentation.

Ideal candidates bring 1–2 years in credentialing, strong communication, and proficiency with Office tools and credentialing software. Join a team dedicated to compassionate family care and efficient patient experiences.