Referral Access & Authorization Specialist

Tryon Medical Partners; Charlotte (NC); On-site; USD 42,000 - 54,000; Full time

Job summary

Tryon Medical Partners is seeking a Referral Authorization Specialist to manage referrals within the practice and coordinating with external facilities. The role is full-time, supporting the TPC at SouthPark, Monday to Friday 8 am to 5 pm.

Responsibilities include processing referrals, prioritizing urgent authorizations, verifying benefits, and maintaining accurate patient information in the EHR. Position requires strong customer service and insurance knowledge.

Qualifications

• High School Diploma or GED required.
• Minimum 2 years’ experience in a health coordination role.
• Demonstrated understanding of industry guidelines and best practices.
• Thorough understanding of insurance coverage and Medical Necessity policies.
• Customer service experience required.
• Knowledge of medical records software preferred.
• Completion of Hepatitis B Vaccine and Flu Vaccine Form will be required; TB test will be required.

Responsibilities

• Complete all referrals for the clinics and ensure they are processed effectively, making sure they are sent to the correct department.
• Prioritize Stat Referral Authorizations.
• Follow up on sent referrals and review patient benefits and eligibility to communicate with clinician and staff pertaining to authorization.
• Keep the system up to date with any changes in information.
• Manage referral status to ensure clinics have updated and current information.
• Completes referrals for patients and coordinates with referring and receiving practices and/or departments.
• Obtain and maintain prior authorizations for diagnostic and ancillary testing.
• Handle sensitive information in a confidential manner.
• All other duties as assigned.
• Clinic support: compile patients’ health information including symptoms, history, exam results, labs, diagnoses, and treatment plans.
• Ensure related reports, labs and demographics are sent to outside facility before appointment.
• Review forms for completeness and proper identification.

Skills

Customer service

Insurance coverage understanding

Attention to detail

Education

High School Diploma or GED

Job description

Tryon Medical Partners is seeking a Referral Authorization Specialist to manage referrals within the practice and coordinating with external facilities. The role is full-time, supporting the TPC at SouthPark, Monday to Friday 8 am to 5 pm.

Responsibilities include processing referrals, prioritizing urgent authorizations, verifying benefits, and maintaining accurate patient information in the EHR. Position requires strong customer service and insurance knowledge.