Referral & Prior Authorization Representative 

We have a Furst-to-hire opportunity for a Referral & Prior Authorization Rep at a regional medical clinic.  The client prefers the Referral & Prior Authorization Rep be bilingual in Spanish as they will deal with many Spanish-speaking patients.  The Referral & Prior Authorization Rep will be responsible for verifying and obtaining authorizations for specialty services, and for setting appointments on behalf of patients.  The Referral & Prior Authorization Rep will act as a liaison between the patient, organization, and external customers. 

Hours: 8am to 4:30pm, Mon-Fri 

Pay: $16.75/hour 

Benefits:   Furst Benefits

Referral & Prior Authorization Rep Responsibilities: 

• Research and correct invalid or incorrect patient demographic insurance information such as phone numbers or insurance policy specifics 

• Verify insurance or self-pay information 

• Maintain current electronic listings of in-network specialty providers, and update on a daily basis 

• Communicate and work with providers, nurses, and other staff to settle unresolved referrals 

• Respond professionally to all inquiries from patients, staff, and payers 

• Accurately document actions taken on a patient record in a timely fashion 

• Maintain and follow through on all referrals and prior authorizations within designated timeframe 

Referral & Prior Authorization Rep Requirements: 

• High school diploma or equivalent 

• Demonstrate computer software skills and aptitude with MS Office and medical billing software 

• Demonstrate overall understanding of medical billing, medical terminology, insurance claims and authorization processing 

• Ability to prioritize, follow through and assume responsibility and use good judgment 

• Communicate effectively with patients, external companies and providers both orally and in writing 

• Five years’ experience in medical billing, referrals, or prior authorizations.  

The Referral & Prior Authorization Rep is a detail-oriented position requiring the ability to work well with minimum to no supervision.  Please apply here or contact Courtney or Denessa at 815-229-7810.