Referral Authorization Representative

CommonSpirit Health; Long Beach (CA); On-site; USD 42,000 - 54,000; Full time

Job summary

CommonSpirit Health in Long Beach, CA, seeks a Referral Authorization Representative to serve as the frontline ambassador and administrative hub for coordinating subspecialty referrals and third-party authorizations. You will manage patient communications, verify demographics, and schedule appointments using our electronic system while handling sensitive data with care.

The role requires strong interpersonal skills, meticulous attention to detail, and proficiency with EMR systems.

Qualifications

• Minimum of 1 year work experience in a medical office involving scheduling and insurance authorizations.
• High School Diploma or equivalent required.
• Bilingual English/Spanish is highly desirable.

Responsibilities

• Obtains authorizations for clinic patients prior to scheduled appointments when required by insurance.
• Ensures the authorization number is documented in the EPM for billing purposes.
• Coordinates and schedules subspecialty referrals as ordered by the provider in a timely fashion.
• Obtains any required third party authorization for ordered referrals.
• Provides subspecialty providers with lab results, test results, or provider progress notes as requested.
• Coordinates and schedules diagnostic procedures/studies as ordered by the provider.

Skills

Customer service

Scheduling

Insurance authorizations

Interpersonal communication

Bilingual English/Spanish (preferred)

Education

High School Diploma or equivalent

Tools

Electronic medical record system (EMR)

EPM documentation

Job description

Job Summary and Responsibilities

As our Referral Authorization Representative, you will be the welcoming front-line ambassador and crucial administrative hub, ensuring exceptional customer service and seamless clinic operations. This position has primary responsibility for coordination and scheduling of all subspecialty referrals and when required obtaining any third party authorization. This individual will also be responsible for obtaining third party authorization prior to patients scheduled clinic visits. Coordinates and schedules diagnostic procedures/studies and if required obtains any third party authorization.

Every day, you will serve as the primary customer service contact, managing communications and distributing calls/messages for all stakeholders. You'll update patient demographics, verify insurance, take accurate messages, and schedule appointments via our electronic system. You'll also perform clerical duties supporting clinic goals and responsibly handle sensitive information.

To be successful in this role, you will possess exceptional interpersonal and communication skills, meticulous attention to detail, strong organization, and proficiency with electronic systems. Your proactive problem-solving and dedication to customer satisfaction will be paramount.

• Obtains authorizations for clinic patients prior to their scheduled appointment when required by their medical insurance.
• Ensures that the authorization number is documented in the EPM for billing purposes.
• Coordinates and schedules subspecialty referrals as ordered by the medical provider in a timely fashion.
• Obtains any required third party authorization for ordered subspecialty referrals.
• Provides the subspecialty provider with lab results, test results or provider progress note as requested.
• Coordinates and schedules diagnostic procedures/studies as ordered by medical provider in a timely fashion.

Job Requirements

Required

• Minimum of one year work experience within a medical office in a related position including scheduling and insurance authorizations.
• High School Diploma or equivalent

Preferred

• Bilingual (English/Spanish) highly desireable

Where You'll Work

Founded in 1923, Dignity Health - St. Mary Medical Center is a 389-bed, acute care, nonprofit hospital located in Long Beach, California. Serving over 80,000 patients annually, the hospital offers a full complement of services including a Level II Trauma Center, Level III NICU, heart care, and orthopedics. Additionally, St. Mary Medical Center has been recognized as an LGBTQ+ Healthcare Equality High Performer by the Human Rights Campaign Foundation. It is a Joint Commission-certified Thrombectomy-Capable Stroke Center and received a Healthgrades 5-Star Award for Heart Failure in 2026. One Community. One Mission. One California