Referrals and Prior Authorization Specialist

LaSante Health; New York (NY); Hybrid; USD 45,000 - 65,000; Full time

Job summary

LaSante Health Center is seeking a Referrals and Prior Authorization Specialist to join our team. The ideal candidate will help ensure patients have access to medications, imaging, and specialty care by managing prior authorization requests and guiding patients through referrals.

Responsibilities include handling insurer prior authorizations for medications and procedures, processing referrals promptly, and offering patients in-network provider options nearby.

Qualifications

• Experience with insurance prior authorizations and/or medical referrals.
• Strong organizational and multitasking abilities.
• Excellent communication and customer service skills.
• Knowledge of health plan networks and medical terminology is a plus.

Responsibilities

• Manage prior authorization requests from insurers for medications, imaging, and procedures.
• Process provider referrals promptly to ensure timely access to specialty and imaging services.
• Offer patients options for in-network providers convenient to their homes.
• Provide clear communication to schedule appointments with outside specialists or imaging facilities.
• Collaborate with providers, insurers, and patients to remove barriers to care.
• Maintain accurate records and track the status of authorizations and referrals.
• Perform additional duties as assigned by supervisors.

Skills

Organizational skills

Communication skills

Customer service

Prior authorizations

Referral processes

Tools

EMR systems

Job description

LaSante Health Center is seeking a Referrals and Prior Authorization Specialist to join our team. The ideal candidate will help ensure patients have seamless access to medications, diagnostic imaging, and specialty care by managing prior authorization requests for insurance and guiding patients through the referral process. This position offers the opportunity to be part of a mission-driven, community-focused organization dedicated to delivering patient-centered care with compassion and respect.

Key Responsibilities

• Manage prior authorization requests from insurance companies for medications, diagnostic imaging, and procedures.

• Process provider referrals promptly and ensure patients have timely access to specialty and imaging services.

• Offer patients options for in-network providers who are convenient to their homes and aligned with their preferences.

• Provide clear communication and assistance to patients in scheduling appointments with outside specialists or imaging facilities.

• Collaborate with healthcare providers, insurers, and patients to eliminate barriers to care.

• Maintain accurate records and track the status of authorizations and referrals.

• Perform additional duties as assigned by supervisors.

Qualifications

• Strong organizational skills and ability to multitask

• Excellent communication and customer service skills

• Proficiency with computers and ability to learn healthcare systems quickly

• Experience with insurance prior authorizations and/or medical referrals preferred

• Knowledge of health plan networks and medical terminology is a plus