Referral Specialist: Patient Access & Authorization

Virginia Mason Franciscan Health; Federal Way (WA); On-site; USD 36,000 - 52,000; Full time

Job summary

Virginia Mason Franciscan Health is seeking a Referral Specialist to orchestrate access to specialized care by managing referrals, pre-authorizations, and related processes. You will obtain clearances for specialty visits, issue referrals for ancillary services, and secure approvals for medications and devices.

The role requires meticulous detail, strong organization, and clear communication to ensure seamless service delivery for patients within the Puget Sound region.

Qualifications

• Accredited medical terminology course or on-the-job training.
• At least 1 year of progressively responsible work experience in a related role.
• None, upon hire.

Responsibilities

• Process referrals and pre-authorizations before patient visits.
• Check insurance eligibility for referrals and document in EMR.
• Coordinate referrals for diagnostic testing, therapy, surgeries, and specialty care.
• Provide patients with cost estimates and explain benefits.
• Notify physicians and patients if a referral is denied or needs more info.
• Update patient records and manage referral communications with clinics.
• Coordinate appointments and ancillary services per policy.
• Respond to routine billing and insurance questions.

Skills

Referral coordination

Insurance verification

Medical terminology

Customer service

Documentation/EMR

Education

Medical terminology course(s) or equivalent

Tools

EMR/EHR

Billing software

Job description

Virginia Mason Franciscan Health is seeking a Referral Specialist to orchestrate access to specialized care by managing referrals, pre-authorizations, and related processes. You will obtain clearances for specialty visits, issue referrals for ancillary services, and secure approvals for medications and devices.

The role requires meticulous detail, strong organization, and clear communication to ensure seamless service delivery for patients within the Puget Sound region.