Senior Referral & Prior Authorization Specialist

University of Rochester; City of Rochester (NY); On-site; USD 28,000 - 38,000; Full time

Job summary

University of Rochester in Rochester, NY, seeks a Referral & Prior Auth Rep III to support scheduling and care through referral management and insurance authorizations. You will liaise with offices, patients, and care teams, ensuring compliant processes and timely communications.

The role requires a High School diploma or equivalent with 2 years of relevant experience; familiarity with medical terminology, scheduling software, and Epic EMR is preferred. Full-time, day shift in Urology.

Qualifications

• High School diploma or equivalent and 2 years of relevant experience.
• Medical Terminology knowledge and scheduling software experience preferred.
• Experience with electronic medical records is preferred.

Responsibilities

• Oversees data and ensures compliance with enterprise standards and referral and prior authorization guidelines.
• Communicates with patients, families, clinical and non-clinical staff to identify barriers to appointment compliance.
• Plans, executes, appeals and follows through on all aspects of referrals and prior authorizations.
• Manages department referrals as liaison between referring offices, specialists, and patients.
• Documents communications and coordinates insurance authorizations in the EMR.
• Performs complex appointment scheduling and ensures timely referrals and ancillary testing.

Skills

Customer service

Medical terminology

Insurance authorization

Data analysis

Electronic medical records

Education

High School diploma or equivalent

2 years of relevant experience

Tools

Epic

Job description

University of Rochester in Rochester, NY, seeks a Referral & Prior Auth Rep III to support scheduling and care through referral management and insurance authorizations. You will liaise with offices, patients, and care teams, ensuring compliant processes and timely communications.

The role requires a High School diploma or equivalent with 2 years of relevant experience; familiarity with medical terminology, scheduling software, and Epic EMR is preferred. Full-time, day shift in Urology.