Referral Authorization & Care Coordination Specialist

Gonzaba Medical Group; San Antonio (TX); On-site; USD 42,000 - 65,000; Full time

Job summary

Gonzaba Medical Group in San Antonio, TX is seeking a Referral Specialist to manage internal referral processes, obtain authorizations from health plans, and communicate outcomes to patients and providers.

You will verify eligibility, process referrals from multiple sources, document actions clearly, and act as a liaison between Managed Care, PCPs, and departments to support medically necessary care.

Qualifications

• Maintains clinical competencies per policy.
• Ensures high level of customer service.
• Communicates tactfully with patients and staff.
• Adheres to in-person and telehealth communications.

Responsibilities

• Run daily referral reports to create work list.
• Process referrals per protocol and document outcomes.
• Verify insurance eligibility and benefits.
• Enter referral data with correct coding.
• Notify patients and referral providers of status.
• Review ongoing care for continued need/eligibility.
• Liaise with Managed Care and PCP on questions.
• Serve as clinic information source on referrals.

Skills

Customer service

Communication

Bilingual English/Spanish

Job description

Gonzaba Medical Group in San Antonio, TX is seeking a Referral Specialist to manage internal referral processes, obtain authorizations from health plans, and communicate outcomes to patients and providers.

You will verify eligibility, process referrals from multiple sources, document actions clearly, and act as a liaison between Managed Care, PCPs, and departments to support medically necessary care.