Referral & Authorization Specialist

Kaiser Permanente; Atlanta (GA); On-site; USD 52,000 - 76,000; Full time

Job summary

Kaiser Permanente in Atlanta, GA is seeking a Referral Services Specialist to initiate and complete internal/external pre-certification referral requests. You will enter data into Epic Tapestry, review benefits and eligibility, assign ICD-10, CPT and HCPCS codes, and communicate with members and providers about referrals.

You will support the QRM/Post-Acute Regional Review Team and maintain accurate documentation.

Qualifications

• Minimum four years of experience in healthcare or a related business area.
• At least six months of experience processing referral requests or other data entry.
• High School Diploma or GED is required.
• Certified coding knowledge or related certifications are preferred.

Responsibilities

• Initiate and complete internal/external pre-certification referral requests.
• Data entry on authorization requests using standard templates and policies.
• Review member eligibility and benefits for services requiring authorization.
• Assign ICD-10, CPT and HCPCS codes per guidelines.
• Communicate with members and providers about referrals and authorization.
• Support the QRM/Post-Acute Regional Review Team operations.

Skills

Data entry

Customer service

Time management

Communication

Education

High School Diploma or GED

Tools

Epic Tapestry

Job description

Kaiser Permanente in Atlanta, GA is seeking a Referral Services Specialist to initiate and complete internal/external pre-certification referral requests. You will enter data into Epic Tapestry, review benefits and eligibility, assign ICD-10, CPT and HCPCS codes, and communicate with members and providers about referrals.

You will support the QRM/Post-Acute Regional Review Team and maintain accurate documentation.