Referral Specialist (Full-time, Days)

Rochester General Hospital; United States; Hybrid; USD 26,000 - 33,000; Full time

Job summary

Rochester General Hospital seeks a Referral Specialist in a hybrid role to coordinate scheduling of diagnostic imaging, specialty testing, and referrals, while obtaining necessary insurance authorizations.

You will document in the EMR, communicate testing instructions to patients, and act as a liaison between patients, providers, and payers to ensure timely access to care.

The role emphasizes excellent customer service, attention to detail, and ability to multitask in a busy outpatient setting.

Qualifications

• High school diploma or GED required.
• 1 year healthcare or scheduling/insurance environment experience preferred.
• Proficiency with Microsoft Word and Excel; ability to navigate multiple systems.
• Strong organizational, communication and customer service skills.
• Ability to multitask and maintain confidentiality.

Responsibilities

• Coordinate scheduling for diagnostic imaging, specialty testing, and physician referrals.
• Obtain insurance authorizations and pre-certifications.
• Review orders and documentation for accuracy before scheduling.
• Verify codes needed for authorization requests.
• Communicate with physicians, patients, facilities and insurers to coordinate care.
• Notify patients of appointments and testing instructions.
• Document authorization details and communications in the EMR.
• Assist self-pay/out-of-network patients with financial resources.
• Maintain knowledge of scheduling workflows and authorization requirements.
• Operate EMR software and office equipment; provide friendly service.
• Support process improvements and additional duties as needed.

Job description

Job Title

Referral Specialist (Hybrid)

Department

Sands Constellation Heart and Vascular Institute,

Location

30 Hagen Drive Suite 100, Rochester, NY 14625

Hours Per Week

40 - Full-time

Schedule

Monday-Friday, 7:30a-4pm

Summary

The Authorization & Scheduling Coordinator is responsible for coordinating and scheduling diagnostic testing, specialty procedures, and referrals while obtaining the necessary insurance authorizations and pre-certifications. This role serves as a key liaison between patients, providers, insurance companies, and healthcare facilities to ensure timely access to care. The coordinator maintains accurate documentation in the electronic medical record (EMR), communicates testing instructions to patients, and promotes an exceptional patient experience through outstanding customer service and attention to detail.

Responsibilities

• Coordinate scheduling for diagnostic imaging, specialty testing, and physician referrals, including MRI, CT, Neurology, Pain Management, and other specialized services.
• Obtain insurance authorizations and pre-certifications by submitting required clinical documentation and working directly with insurance carriers.
• Review physician orders and medical documentation to ensure accuracy and completeness prior to scheduling.
• Verify appropriate procedure and diagnosis codes needed for authorization requests.
• Communicate with physicians, patients, healthcare facilities, and insurance companies to coordinate timely care.
• Notify patients of scheduled appointments, testing instructions, preparation requirements, and arrival times.
• Document all authorization information, patient communications, and payer interactions accurately within the electronic medical record (EMR).
• Assist self-pay and out-of-network patients by connecting them with appropriate financial resources.
• Maintain current knowledge of scheduling workflows, insurance authorization requirements, and departmental policies and procedures.
• Operate standard office equipment and utilize electronic systems, including EMR software, telephones, printers, copiers, and fax machines.
• Deliver exceptional customer service by greeting and assisting patients professionally in person and by telephone.
• Support continuous process improvement and perform additional duties as assigned to promote efficient practice operations.

Required Qualifications

• High school diploma or GED required.
• Minimum of one year of experience in a healthcare, medical office, scheduling, registration, or insurance authorization environment preferred.
• Proficiency with Microsoft Office applications, including Word and Excel, and the ability to navigate multiple computer systems.
• Strong organizational, communication, and customer service skills.
• Ability to multitask, prioritize competing responsibilities, and work efficiently in a fast-paced environment.
• Strong attention to detail and accuracy when working with patient records, insurance information, and scheduling.
• Ability to maintain confidentiality and exercise professionalism when interacting with patients, providers, and staff.

Preferred Qualifications

• Associate degree in a healthcare-related field.
• Experience obtaining insurance authorizations and pre-certifications.
• Knowledge of medical terminology.
• Orthopedic terminology experience strongly preferred.
• Experience working with electronic medical records (EMR/EHR).
• Familiarity with diagnostic imaging, specialty testing, and referral coordination.
• Experience working with insurance carriers, payer requirements, and medical necessity documentaion.

EDUCATION

LICENSES / CERTIFICATIONS

PHYSICAL REQUIREMENTS

Sedentary - Sedentary roles are primarily office-based and require prolonged sitting (67-100% of the workday) with minimal physical effort and lifting limited to under 10 lbs. Fine motor skills are necessary for computer work, writing, and telephone use, supported by clear visual and auditory ability. Cognitive and emotional demands are high due to extended concentration, frequent interruptions, independent decision-making, and information processing. Although physical exposure is low, administrative areas within healthcare environments may occasionally involve contact with infectious agents. Some roles may require flexible hours, TB screening, or a valid driver's license.

For disease specific care programs refer to the program specific requirements of the department for further specifications on experience and educational expectations, including continuing education requirements.

Any physical requirements reported by a prospective employee and/or employee's physician or delegate will be considered for accommodations.

PAY RANGE

$19.00 - $24.00

CITY

Rochester

POSTAL CODE

14625

The posted pay range is a good faith representation of potential base pay for this position. It may be modified in the future and eligible for additional pay components. Individual annual salaries/hourly rates could vary based on position details and FTE. Pay is