Referral Specialist I

As our Referral Specialist, you will orchestrate patient access to specialized care by expertly managing all referral and authorization processes.

Every day, you will proactively obtain clearances for specialty visits, issue referrals for ancillary services (consults, imaging, labs), and secure approvals for medications, DME, home health, and other vital services.

To be successful in this role, you will demonstrate meticulous attention to detail, strong organizational skills, and clear communication to ensure seamless and efficient service delivery for our patients.

• Gather, verify, and process referrals, authorizations, and pre-certifications by working closely with physician(s), patients and insurance payers.
• Communicate detailed information and answer patient questions regarding their health care plan; provide answers to billing and insurance clarification questions.
• Set up appointments, coordinate clinic visits, and any special arrangements such as transportation, interpreter services, specialty care, etc.
• Coordinate flow of information between medical clinic and referral authorization department to secure a valid referral for clinic patients.
• Enter referrals, documents, communications and action into the system, as appropriate.
• Prioritizes referrals by their urgency and addresses them in a timely manner.

Required

• High School Graduate or GED 

Dignity Health’s Pacific Central Coast Health Centers (PHC) is a non-profit Community clinic organization comprised of more than 40 health centers located primarily from Ventura to Templeton, spanning the coast. Our experienced physicians and advanced practice providers offer a wide range of primary and specialty care services. PHC is a part of Dignity Health Central Coast’s award-winning network of outstanding hospitals, imaging centers, laboratories, and post-acute services.

One Community. One Mission. One California 

Depending on the position offered, CommonSpirit Health offers a generous benefit package, including but not limited to medical, prescription drug, dental, vision plans, life insurance, paid time off (full-time benefit eligible team members may receive a minimum of 14 paid time off days, including holidays annually), tuition reimbursement, retirement plan benefit(s) including, but not limited to, 401(k), 403(b), and other defined benefits offerings, as may be amended from time to time. For more information, please visit our Total Rewards.

Unless directed by a Collective Bargaining Agreement, applications for this position will be considered on a rolling basis. CommonSpirit Health cannot anticipate the date by which a successful candidate may be identified.