Referral Specialist

Southernmed; Lexington (SC); Presencial; USD 36.000 - 48.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Paid Time Off

Matching 401K

Annual Merit Increases

Mental Health and Counseling Programs

Dental and Orthodontic Coverage

Vision Insurance

Health Care with Low Premiums

Short-term Disability

Access to Virtual Health & Wellness

Descripción de la vacante

Southernmed seeks a Referral Specialist to support patient experience by efficiently processing referrals, prior authorizations, and imaging requests. The role emphasizes accuracy, timeliness, and adherence to regulatory standards in a pediatric/outpatient health setting.

You will collaborate with care teams to ensure smooth authorization flows, maintain records, and uphold high-quality service for families and providers.

Formación

• High school diploma or equivalent required; associate or bachelor’s degree preferred.
• Minimum 1–2 years of credentialing experience, preferably in a pediatric or outpatient healthcare setting.
• Knowledge of credentialing processes, insurance payers, and regulatory standards (e.g., CAQH, Medicare, Medicaid).
• Strong organizational skills with high attention to detail.
• Excellent written and verbal communication skills.
• Proficiency with credentialing software, Microsoft Office (Word, Excel, Outlook), and practice management systems.
• Ability to work independently and manage multiple deadlines simultaneously.

Responsabilidades

• Facilitates outgoing referral requests and obtains prior authorization when necessary.
• Obtains prior authorization for patient medications.
• Schedules and obtains prior authorization for diagnostic imaging requests.
• Meets position requirements and performs essential functions.
• Completes all mandatory training as required.
• Performs other duties as assigned.

Conocimientos

Credentialing knowledge

Organizational skills

Communication skills

Independent work

Multi-tasking

Educación

High school diploma

Associate or Bachelor's degree preferred

Herramientas

Credentialing software

Microsoft Office

Practice management systems

Descripción del empleo

Description

What it means to be a Referral Specialist with Us

We value our families we serve, our communities and our team members. As a Referral Specialist you support a positive patient experience by efficiently processing requests for referrals, prior authorizations, and diagnostic imaging.

Our Mission

At our offices, we do our best each day to provide high quality, compassionate health care to the families in our communities, treating each child as our own. Our staff and providers strive to make each encounter pleasant and informative while respecting the time and individual needs of our patients and families.

Benefits that Matter!

• Paid Time Off
• Matching 401K
• Annual Merit Increases
• Mental Health and Counseling Programs
• Dental and Orthodontic Coverage
• Vision Insurance
• Health Care with Low Premiums
• Short-term Disability
• Access to Virtual Health & Wellness

What a day looks like as a Referral Specialist

• Facilitates outgoing referral requests which include obtaining prior authorization when necessary.
• Obtains prior authorization for patient medications.
• Schedules and obtains prior authorization for diagnostic imaging requests.
• Meets position requirements and performs essential functions.
• Completes all mandatory training as required.
• Performs other duties as assigned.

Requirements

Qualifications

• High school diploma or equivalent required; associate or bachelor's degree preferred.
• Minimum 1–2 years of credentialing experience, preferably in a pediatric or outpatient healthcare setting.
• Knowledge of credentialing processes, insurance payers, and regulatory standards (e.g., CAQH, Medicare, Medicaid).
• Strong organizational skills with high attention to detail.
• Excellent written and verbal communication skills.
• Proficiency with credentialing software, Microsoft Office (Word, Excel, Outlook), and practice management systems.
• Ability to work independently and manage multiple deadlines simultaneously.

Working Conditions & Physical Requirements

• Indoor, temperature controlled, smoke free environment.
• May at times work under stressful situations.
• Handicapped accessible.

Pay is detemined by years of experience as well as location(s) of the office. We hope that you find this position as an exciting opportunity and look forward to the potential of speaking with you!