Referral Specialist

Metro Community Health Center; Pittsburgh (Allegheny County); On-site; USD 36,000 - 48,000; Full time

Job summary

Metro Community Health Center in Pittsburgh, PA seeks a detail-oriented healthcare administrator to support prior authorizations, referrals, and insurance verification in a busy clinical office. The role requires 1–2 years of relevant experience and familiarity with EMR/EHR systems.

High school diploma is required; CMA credential is preferred. You will collaborate with clinicians, front-desk staff, and providers while maintaining patient confidentiality in a fast-paced environment.

Qualifications

• High school diploma or equivalent required.
• 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.

Responsibilities

• Perform prior authorizations and referrals for patients.
• Verify insurance coverage and benefits.
• Maintain up-to-date patient records in EMR/EHR systems.
• Communicate with patients and providers professionally, including telephone etiquette.
• Coordinate referrals for diagnostics, specialty care, labs, or therapies.

Skills

Medical terminology

CPT/ICD-10 coding

Referral processes

Insurance documentation

Telephone etiquette

Organization

Communication

Education

High school diploma or equivalent

Certified Medical Assistant (preferred)

Tools

EMR/EHR systems

Job description

Job Details

Job Location: Pittsburgh, PA 15218 Position Type: Full Time

POSITION REQUIREMENTS:

Education/Experience

• High 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/Abilities

• Working 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/Abilities

• Certified 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.

QualificationsPOSITION REQUIREMENTS:

Education/Experience

• High 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/Abilities

• Working 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/Abilities

• Certified 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.