Referral & Authorization Pro (Cape Area)

The Vascular Care Group; Hyannis (MA); On-site; USD 34,000 - 41,000; Full time

Job summary

The Vascular Care Group is seeking a detail-oriented Referral Specialist to secure referrals and insurance authorizations for upcoming appointments. You will act as the primary liaison between patients, referring providers, and insurers, ensuring all documentation is complete for each visit.

You will review schedules, obtain referrals, submit prior authorizations, verify coverage, and track statuses while maintaining HIPAA compliance and professional communication in a fast-paced clinical

Qualifications

• High School diploma minimum; degree preferred.
• 1+ year experience obtaining referrals and prior authorizations.
• Vascular, cardiology, or surgical setting experience preferred.
• Familiar with Medicare/Medicaid and payer requirements.
• Proficient with EMR and payer portals; CPT/ICD-10 knowledge.
• Strong communication, detail-oriented, and HIPAA compliant.

Responsibilities

• Review schedules to identify needed referrals/authorizations.
• Obtain referrals from PCPs for visits, ultrasounds, and procedures.
• Submit and follow up on prior authorization requests.
• Verify insurance eligibility and payer requirements.
• Communicate with referring offices for missing referrals.
• Inform patients of status and reschedule as needed.
• Document referral activity with reference numbers and dates.
• Track pending referrals and escalate delays.
• Coordinate with clinical staff and billing.
• Respond to denials and submit retro-authorization when appropriate.
• Maintain knowledge of referral requirements.
• Protect patient confidentiality and HIPAA compliance.
• Complete ad hoc projects.
• Local travel as needed.

Skills

Communication skills

Attention to detail

Multitasking

Professional demeanor

Microsoft Office proficiency

Education

High School Diploma

Associate or Bachelor's degree preferred

Tools

Electronic Medical Records (EMR)

Payer portals

Microsoft Office

Job description

The Vascular Care Group is seeking a detail-oriented Referral Specialist to secure referrals and insurance authorizations for upcoming appointments. You will act as the primary liaison between patients, referring providers, and insurers, ensuring all documentation is complete for each visit.

You will review schedules, obtain referrals, submit prior authorizations, verify coverage, and track statuses while maintaining HIPAA compliance and professional communication in a fast-paced clinical