Referral & Authorization Specialist

Hollister Incorporated; Mount Juliet (TN); On-site; USD 42,000 - 52,000; Full time

Benefits offered by this job

Medical, Dental and Vision Insurance

401k Plan with Company Match

PTO and Paid Holidays

Employee Discounts

EAP

Job summary

ABC Medical is seeking a Referral Specialist to verify medical documentation, obtain pre-authorizations, and ensure compliance with local coverage determinations. You will update databases and communicate with providers, payors, and leadership to meet service levels.

Minimum qualifications include a high school diploma and 2+ years of experience, with basic payor knowledge and strong attention to detail. The role offers comprehensive benefit plans and a supportive team environment.

Qualifications

• High School Diploma or equivalent work experience.
• 2+ years of work experience.
• Basic understanding of payor guidelines.
• Analytical skills and attention to detail.
• Ability to work well in a team environment.

Responsibilities

• Verify, obtain, review, and determine that medical documents meet local coverage determinations and regulatory requirements.
• Obtain prior authorization and/or referrals.
• Update customer database and document files accordingly.
• Regularly communicate with health care providers, payors, and sales managers.
• Adhere to HIPAA guidelines and regulations.

Skills

Analytical skills

Attention to detail

Organized

Basic Microsoft skills

Team player

Education

High School Diploma or equivalent

Tools

Microsoft Office

Job description

ABC Medical is seeking a Referral Specialist to verify medical documentation, obtain pre-authorizations, and ensure compliance with local coverage determinations. You will update databases and communicate with providers, payors, and leadership to meet service levels.

Minimum qualifications include a high school diploma and 2+ years of experience, with basic payor knowledge and strong attention to detail. The role offers comprehensive benefit plans and a supportive team environment.