Referral Specialist

South Texas Health System Clinics; McAllen (TX); On-site; USD 35,000 - 52,000; Full time

Benefits offered by this job

Competitive compensation

Excellent health plans

401(K) with company match

Generous PTO

Job summary

Independence Physician Management (IPM) is seeking a Referral Specialist to schedule patient referrals, pre-authorize tests, and coordinate with providers and facilities. You will review clinical data to determine medical necessity and ensure services align with IPM’s mission and values.

The role emphasizes clear communication with clinics, patients, and hospitals, supporting efficient patient care and adherence to insurance requirements.

Qualifications

• High school diploma or GED required.
• Must maintain CPR certification.
• Minimum of two years of clinical experience.
• Knowledge of administrative and clerical procedures and systems.
• EMR Experience

Responsibilities

• Schedule referrals and pre-authorize tests/procedures.
• Communicate with patients, clinics, and hospitals.
• Review clinical data to report medical necessity to insurers.

Skills

CPR certification

Clinical experience

EMR Experience

Communication skills

Education

High school diploma or GED

Tools

Office software

Job description

Responsibilities

Website: sthsclinics.com. The Referral Specialist is responsible for scheduling referrals for patients and providers, as well as pre-authorizing and pre-certifying tests/procedures. Scheduling of other tests with facilities at the request of providers and/or staff. Communicates effectively with patients, clinics, and hospitals. Reviews clinical data to report medical necessity to insurance companies. Performs all work with accord to the mission, vision, and values of the practice.

• Responsible for scheduling referrals for patients, providers, pre-authorizing & pre-certing tests/procedures. Scheduling of other tests with facilities at the request of providers and/or staff.
• Directly communicates with the clinics, referred to clinics, and patients.
• Reviews clinical data to report medical necessity to insurance companies. Performs all work with accord to the mission, vision, and values of the practice.

About IPM

Independence Physician Management (IPM), a subsidiary of UHS, was formed in 2012 as the physician services unit of UHS. IPM develops and manages multi-specialty physician networks and urgent care clinics which align with UHS acute care facilities. It also provides select services for the Behavioral Health division of UHS. Through continuing growth, IPM operates in 11 markets across six states and the District of Columbia. Our leadership team, practitioners, and teams of healthcare professionals are collectively dedicated to improving the health and wellness of people in the communities we serve.

Benefit and Rewards Highlights

• Retention Bonus Program if offered.
• Loan Forgiveness Program if offered.
• Challenging and rewarding work environment
• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401(K) with company match and discounted stock plan
• SoFi Student Loan Refinancing Program
• Tuition savings to continue your nursing education with Chamberlain University
• Career development opportunities within UHS and its 300+ Subsidiaries!
• Pet Insurance
• More information is available on our Benefits Guest Website: benefits.uhsguest.com

About Universal Health Services

Headquartered in King of Prussia, PA, Universal Health Services, Inc. (NYSE: UHS) is one of the nation’s largest and most respected providers of hospital and healthcare services. Since our founding in 1979, UHS has grown steadily into a premier Fortune 500® corporation perennially recognized by multiple esteemed national rating entities. Through its subsidiaries, UHS operates inpatient acute care facilities, inpatient behavioral health facilities, outpatient and other facilities, nationwide virtual behavioral health services, an insurance offering, a physician network and various related services with physical locations in the U.S., Puerto Rico, Ireland and United Kingdom. www.uhs.com.

Requirements

• High school diploma or GED required
• Must maintain CPR certification
• Minimum of two years of clinical experience required.
• Knowledge of administrative and clerical procedures and systems, and other office procedures and terminology.
• Knowledge of electronic equipment, computer hardware and software, including applications and programming.
• Knowledge of principles and processes for providing customers and personal services. This includes customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction.
• EMR Experience

Qualifications

• High school diploma or GED required
• Must maintain CPR certification
• Minimum of two years of clinical experience required.
• Knowledge of administrative and clerical procedures and systems, and other office procedures and terminology.
• Knowledge of electronic equipment, computer hardware and software, including applications and programming.
• Knowledge of principles and processes for providing customers and personal services. This includes customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction.
• EMR Experience

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.