Referral & Scheduling Specialist - Patient Access

Franciscan Medical Group; Federal Way (WA); On-site; USD 36,000 - 52,000; Full time

Job summary

Franciscan Medical Group is seeking a Referral Specialist to orchestrate patient access to specialized care by managing referral and authorization processes.

You will obtain clearances for specialty visits, issue referrals for ancillary services, and secure approvals for medications, DME, home health, and other vital services. This role requires meticulous attention to detail, strong organization, and clear communication to ensure seamless care delivery for our patients.

Qualifications

• Successful completion of an accredited medical terminology course(s) or equivalent on the job training, upon hire.
• One year of progressively responsible work experience that would demonstrate attainment of the requisite job knowledge/abilities.
• None, upon hire

Responsibilities

• Processes referral orders and/or pre-authorizations for diagnostic testing, therapy, surgeries and specialty care.
• Ensures insurance eligibility checks are conducted before the patient is seen, via verification or escalation.
• Provides information to patients about billing and insurance and explains coverage details.
• Notifies physicians and patients when referrals are denied or if additional information is needed.
• Updates the patient’s medical record and coordinates with referring clinics as needed.
• Coordinates patient appointments and ancillary services in alignment with authorized referrals.
• Responds to routine billing/insurance questions and provides cost estimates when requested.
• Coordinates patient education materials and instructs patients about pre-visit requirements.

Skills

Medical terminology

Patient scheduling

Insurance verification

Education

Medical terminology course

Job description

Franciscan Medical Group is seeking a Referral Specialist to orchestrate patient access to specialized care by managing referral and authorization processes.

You will obtain clearances for specialty visits, issue referrals for ancillary services, and secure approvals for medications, DME, home health, and other vital services. This role requires meticulous attention to detail, strong organization, and clear communication to ensure seamless care delivery for our patients.