Prior Authorization (PA) / Referral Specialist

Prior Authorization (PA) / Referral Specialist 3.7 3.7 out of 5 stars Edina, MN $20 - $26 an hour - Full-time Southdale Pediatric Associates, Ltd. 12 reviews $20 - $26 an hour - Full-time Prior Authorization / Referral Specialist (Full-Time)

Location:

Edina, MN At Southdale Pediatrics, we've been caring for children and families since 1948. As an independent group of Pediatricians and Allergists, our mission is simple: provide high-quality care with clinical excellence and genuine compassion in a warm, welcoming environment. We're looking for a full-time Prior Authorization / Referral Specialist to join our team! This role is based in our Edina clinic, with occasional travel to our other clinics. The schedule is primarily daytime hours (8:00 AM-5:00 PM). Why this role matters In this position, you play a key role behind the scenes—helping patients get timely access to medications, tests, and specialty care. Your work directly supports both our care teams and the families we serve. What you'll do Submit prior authorization and referral requests for medications, procedures, and treatments Review medical documentation and insurance requirements to ensure accurate submissions Verify patient insurance coverage and determine authorization/referral needs Communicate with insurance companies, providers, and patients regarding status updates Track requests, follow up on outstanding items, and ensure timely approvals Assist with denied requests by gathering information and submitting appeals Help patients and families understand the authorization and referral process Collaborate with clinic staff to keep workflows running smoothly Maintain compliance with HIPAA and other healthcare regulations Support reporting and tracking efforts to improve processes over time Other duties as assigned What you'll bring High school diploma or GED (required) Strong knowledge of medical terminology and coding (required) Associate's degree in a related field (preferred) Prior Authorization Certification (preferred)

Compensation & Schedule Job Type:

Full-time Pay:

$20 - $26 per hour Expected hours: 32-40 per week Benefits 401(k) 401(k) matching Health insurance Dental insurance Disability insurance Life insurance Vision Insurance Paid time off Employee Assistance Program (EAP)

Job Type:

Full-time Pay:

$20.00 - $26.00 per hour

Benefits:

401(k) 401(k) matching Dental insurance Disability insurance Employee assistance program Health insurance Life insurance Paid time off Vision insurance

Experience:

Medical terminology: 2 years (Required)

Healthcare:

2 years (Required) Ability to

Commute:

Edina, MN (Required) Ability to

Relocate:

Edina, MN:

Relocate before starting work (Required)

Work Location:

In person