Referral & Access Lead

Northwest Human Services, Inc.; Salem (OR); On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

Healthcare insurance plans

Group Life: Short-Term & Long-Term Dis

403(b) retirement plan with employer 2

Flex Spending Account

PTO - 10 hours a month for FT

Paid holidays and floating holidays

Continuing Education & Training

Employee Healthy Living Program – Gym

Job summary

Northwest Human Services, Inc. in Salem, OR, is seeking a Referral Specialist Lead to guide the Referrals team, coordinate complex referrals, and improve patient access to care.

This role focuses on pre-authorizations, workflows, and collaboration with providers, insurance partners, and leadership. The ideal candidate will mentor staff, ensure timely referrals, and maintain up-to-date knowledge of insurance requirements and coding.

Qualifications

• High school diploma or equivalent required.
• Minimum of two years of experience in clinic referrals.
• Minimum of six months of experience working at Northwest Human Services in any capacity using clinical systems.
• Proficiency in medical terminology.

Responsibilities

• Provide day-to-day technical guidance, coaching, and support to Referral Specialists.
• Serve as a subject matter expert for referral processes, pre-authorizations, and department workflows.
• Assist with onboarding and training new Referral Specialists.
• Support team members with complex or escalated referral and authorization requests.
• Initiate and coordinate medical, mental health, and medication pre-authorizations with insurance companies and other third-party payers.
• Facilitate timely patient referrals to specialists and external healthcare facilities.
• Coordinate patient appointments and interpreter services when needed.
• Communicate referral status, authorization requirements, and potential barriers to providers and patients.
• Serve as a super user for referral systems and collaborate with IT to troubleshoot issues and improve workflows.
• Maintain current knowledge of insurance requirements, payer guidelines, medical terminology, ICD-10, and CPT coding.
• Maintain accurate and up-to-date specialist information.
• Support compliance, confidentiality, patient safety, and quality improvement initiatives.

Skills

Technical guidance

Coaching

Collaboration

Prioritization

Patient-centered service

Education

High school diploma or equivalent

Tools

Clinical systems

Job description

Northwest Human Services, Inc. in Salem, OR, is seeking a Referral Specialist Lead to guide the Referrals team, coordinate complex referrals, and improve patient access to care.

This role focuses on pre-authorizations, workflows, and collaboration with providers, insurance partners, and leadership. The ideal candidate will mentor staff, ensure timely referrals, and maintain up-to-date knowledge of insurance requirements and coding.