Referral Specialist

Metro-Community-Health-Center; Pittsburgh (Allegheny County); On-site; USD 38,000 - 48,000; Full time

Job summary

Metro-Community-Health-Center in Pittsburgh is seeking an administrative professional to support prior authorization, referrals, and insurance verification in a fast-paced primary care setting. The role requires knowledge of medical terminology, CPT/ICD-10 coding, experience with EMR/EHR systems, and strong organizational and communication skills with strict patient confidentiality.

You will coordinate authorizations, verify coverage, manage documentation, and assist clinicians and care teams to

Qualifications

• Knowledge of medical terminology and coding concepts.
• Experience with EMR/EHR systems and healthcare administration workflows.
• Familiarity with Medicare/Medicaid, payer requirements, and authorization workflows.
• Strong organizational skills and attention to detail; ability to manage multiple tasks.

Skills

Medical terminology

CPT/ICD-10 codes

Referral processes

Insurance documentation

EHR/EMR systems

Attention to detail

Verbal and written communication

multitasking

Certified Medical Assistant

Education

High school diploma or equivalent

Job description

POSITION REQUIREMENTS:Education/ExperienceHigh school diploma or equivalent required.Minimum of 1–2 years of experience in prior authorization, referral coordination, insurance verification, medical office support, or related healthcare administrative work.Experience working with electronic medical records or electronic health records.Familiarity with Medicare, Medicaid, managed care plans, payer requirements, and authorization workflows.Skills/AbilitiesWorking knowledge of medical terminology, CPT and ICD-10 codes, referral processes, and insurance documentation requirements.Strong organizational skills, attention to detail, and ability to follow tasks through to completion.Excellent verbal and written communication skills, including professional telephone etiquette.Ability to manage multiple priorities in a fast-paced clinical office environment.Ability to handle sensitive patient information with professionalism and confidentiality.Preferred Skills/AbilitiesCertified Medical Assistant credential preferred.Experience in a primary care, family practice, community health, or federally qualified health center setting preferred.Experience coordinating referrals for diagnostics, specialty care, labs, durable medical equipment, home health care, or physical therapy preferred.POSITION REQUIREMENTS:Education/ExperienceHigh school diploma or equivalent required.Minimum of 1–2 years of experience in prior authorization, referral coordination, insurance verification, medical office support, or related healthcare administrative work.Experience working with electronic medical records or electronic health records.Familiarity with Medicare, Medicaid, managed care plans, payer requirements, and authorization workflows.Skills/AbilitiesWorking knowledge of medical terminology, CPT and ICD-10 codes, referral processes, and insurance documentation requirements.Strong organizational skills, attention to detail, and ability to follow tasks through to completion.Excellent verbal and written communication skills, including professional telephone etiquette.Ability to manage multiple priorities in a fast-paced clinical office environment.Ability to handle sensitive patient information with professionalism and confidentiality.Preferred Skills/AbilitiesCertified Medical Assistant credential preferred.Experience in a primary care, family practice, community health, or federally qualified health center setting preferred.Experience coordinating referrals for diagnostics, specialty care, labs, durable medical equipment, home health care, or physical therapy preferred.