Job Description

Qualifications and Requirements:

To perform this job successfully, and individual must be able to perform each essential job duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/or ability required.  This job description in no way implies that these are the only duties to be performed and may be modified, interpreted and/or applied in any way as necessary. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties.


Essential Job Duties:

  • Obtains Referral notes from specialists as required.
  • Acquires and documents referral information from physicians, patients, and insurance carriers.
  • Reviews referral paperwork to ensure that referrals are appropriate for the insurance carriers.
  • Ensures that prior authorizations are completed for referrals as required by the insurance carriers.
  • Follows-up to ensure that all required documents have been received by insurance carrier and referral is processed. 
  • Runs and reviews ordered/processed referrals reports bi-weekly to ensure that referrals are performed.


Required Education, Experience, Certificates & Licenses:

  • High School Diploma or GED.
  • Experience in medical records or referrals preferred.
  • Any combination of experience and/or education that provides the skills and sensitivity.


Required Language Skills:

  • Ability to comprehend and compose instructions, correspondence and communications in English in both oral and written format.


Physical Requirements:

  • Ability to occasionally exert enough force to move objects weighing up to 10 pounds.
  • Ability to continuously remain in a stationary position.
  • Ability to occasionally move about inside the work place to access files, office machinery, etc.
  • Possesses hand-eye coordination and manual dexterity necessary to constantly operate computer, telephone, and other office machinery.
  • Possesses close visual acuity necessary to accurately record and view information on a computer monitor, handwritten and typed documents.
  • Ability to discern the nature of sounds at a normal spoken volume.


Other Required Knowledge, Skills, and Abilities:

  • Ability to add, subtract, multiply and divide, using whole numbers, common fractions and decimals.
  • Ability to gather data in an organized fashion from varied sources.
  • Ability to take direction and perform assignments accordingly.
  • Knowledge of all aspects of insurance referral process.
  • Computer literacy required.
  • Knowledge of Electronic Health Records preferred.
  • Understands covered services and contracted physicians enrolled with various insurance carriers.
  • Ability to provide excellent customer service by mail, telephone, and in-person.


Work Environment & Conditions:

  • Work environment is typical of an administrative office setting with no substantial exposure to adverse environmental conditions.