Referral & Precertification Specialist

Covenant Health; Idaho; Hybrid; USD 42,000 - 56,000; Full time

Job summary

Covenant Medical Group is seeking a Clinical Referral Specialist to manage scheduling for specialty facilities and procedures, create and register new patient charts, verify addresses, and submit insurance eligibility. They prioritize orders, obtain pre-certifications and follow up on referrals and authorizations to ensure timely patient care.

The specialist collaborates with patients, providers, and nursing staff to ensure a team-based approach to patient care.

Qualifications

• One to two years of experience in Referrals and Diagnostics with pre-certification knowledge.
• Familiarity with medical terminology and insurance processes.
• Ability to navigate EHRs and perform scheduling tasks accurately.

Responsibilities

• Schedule inpatient/outpatient tests, procedures, and appointments with providers.
• Register new patient charts and verify patient information.
• Submit insurance eligibility and obtain pre-certifications for referrals.
• Maintain referral logs and coordinate with patients, providers, and nursing staff.
• Communicate appointment details and special instructions clearly to patients.

Skills

Medical terminology

ICD-10 coding

CPT coding

Electronic health records

Communication skills

Education

High school diploma or GED

Tools

EHR systems

Scheduling software

Job description

Covenant Medical Group is seeking a Clinical Referral Specialist to manage scheduling for specialty facilities and procedures, create and register new patient charts, verify addresses, and submit insurance eligibility. They prioritize orders, obtain pre-certifications and follow up on referrals and authorizations to ensure timely patient care.

The specialist collaborates with patients, providers, and nursing staff to ensure a team-based approach to patient care.