REFERRAL SPECIALIST - FULL TIME

JumpStart Games; Lakeland (FL); On-site; USD 42,000 - 54,000; Full time

Job summary

JumpStart Games is seeking a Referral Specialist to obtain referrals, prior authorizations, and pre-determinations that enable patients to access healthcare provider services. The role requires accurate documentation and adherence to insurer guidelines.

Responsibilities include daily workload management, communicating with physician offices, and maintaining up-to-date processes across specialties. Strong typing speed and IDX scheduling familiarity are preferred.

Qualifications

• High school diploma or GED required; 4+ years related experience may substitute.
• Experience with insurance referrals, prior authorizations, and pre-determinations preferred.
• Strong communication skills, both oral and written, are essential.
• Ability to type at least 35 words per minute and to navigate IDX scheduling.

Responsibilities

• Obtain authorizations, referrals, and pre-determinations for clinic patients daily.
• Process authorizations and referrals per insurer guidelines and clinical requirements.
• Document all actions in Clinic systems and manage referrals and reservations.
• Maintain clear communication with physician offices and support staff to ensure efficient referrals processing.
• Attend departmental meetings and keep specialty processes up to date.

Skills

Communication skills

Typing 35 wpm

IDX scheduling familiarity

Multi-tasking

Organizational skills

Education

High School diploma or GED

4 years related experience

Tools

Epic

Athena/IDX

ICD-10

CPT/HCPCS codes

Medical terminology

Job description

Description

Description
Summary/Objective: A Referral Specialist is responsible for obtaining insurance referrals, prior authorizations, and pre-determinations that allow a patient to access the services of the Clinic’s health care providers.
Essential Functions

• Complete daily workload assignments, keeping to the department standard for productivity, for obtaining authorizations, referrals, or pre-determinations for clinic patients.
• Accurately process authorizations, referrals, and predeterminations per insurance carrier guidelines and clinical specialty requirements.
• Accurately document all actions taken to obtain authorizations, referrals, and pre-determinations in Clinic systems. This includes building referrals and signing off on reservations.
• Maintain clear and positive communications with physician offices and support staff to ensure efficient handling of referrals, authorizations, and pre-determinations.
• Attends departmental meetings (including the daily huddle) and keeps the processes of your assigned specialties up to date.
  

Requirements
Required Education and Experience: High School Graduate or equivalent (GED and 4 years of related experience may be equivalent).
Preferred Education and Experience: One to two years referral, authorization, and pre-determination experience preferred. Prefer experience working with Epic, Athena/IDX, ICD-10, CPT / HCPCS codes, and proficiency with medical terminology
Additional Eligibility Qualifications: Knowledge of insurance plan referral requirements and referral processes. Ability to demonstrate excellent communication skills (oral and written). Ability to retain detailed information to perform daily duties and assist physician offices with proper referral processing. Ability to type 35wpm and have basic knowledge of IDX scheduling. Ability to multi-task in a fast paced environment and possess excellent organizational skills. Advanced telephone skills as a primary instrument of communication.