Referral and Authorization Specialist (with specialty practice) Western Nephrology - 3.9 Wheat Ridge, CO Job Details Full-time $21 - $23 an hour 22 hours ago Benefits Health savings account Paid holidays Disability insurance Health insurance Dental insurance 401(k) Paid time off Parental leave Employee assistance program Vision insurance 401(k) matching Employee discount Life insurance Pet insurance Qualifications Customer communication Overseeing health insurance pre-certification Electronic health records (EHR) management High school diploma or GED Healthcare referral management Health insurance referral requirements Full Job Description This position is onsite only - there are no hybrid or remote options available. Days of work are Monday through Friday. The hours may vary from 8:00 am-5:00 pm or 8:30 am-5:00 pm depending on length of lunch. Are you a detail-oriented healthcare support professional who thrives in a dynamic environment? Western Nephrology is seeking a dedicated team member to support our clinic operations through prior authorizations, specialty referrals, and patient scheduling. In this vital role, you will serve as a bridge between patients, clinical care teams, and insurance carriers—ensuring our nephrology patients receive seamless, timely care while navigating complex insurance processes.

Key Responsibilities Prior Authorizations & Referrals:

Submit, track, and obtain prior authorizations and referrals for new and established patients; actively review databases to ensure all approvals are secured prior to appointment dates.

Clinic & Billing Collaboration:

Partner closely with clinic staff, providers, and billing teams to ensure authorization accuracy, communicate approval/denial statuses, and minimize claim denials.

Patient Financial Navigation:

Clearly answer patient inquiries regarding copays, deductibles, patient-responsible portions, and write-offs.

Records & Administration:

Process third-party medical record requests efficiently while maintaining strict compliance with HIPAA guidelines. Qualifications & Requirements High School Diploma or equivalent required. 2 years handling provider referrals and prior authorizations in a specialty care setting. EMR experience What Makes You a Great Fit Solid understanding of commercial and government insurance carrier procedures, medical terminology, and HIPAA regulations. Demonstrated ability to assess complex situations, anticipate issues, and prioritize urgent patient appointments. Excellent written and verbal communication skills with an emphasis on active listening, empathy, and exceptional customer service. Proven ability to multitask and complete high-volume assignments independently while maintaining a strong team-player mindset. We offer a supportive team culture, competitive compensation, and the opportunity to make a meaningful difference in our patients' lives every day. We offer a team based culture where we appreciate , recognize , and support each other's successes. We hire people that have a positive attitude and live to serve others! Do you want to have fun and work hard ? Come grow your medical career with us! Competitive compensation package includes medical, dental, vision, life, long term disability, health savings account, 401k retirement with generous matches, paid holidays, PTO and a cash out option after one year of employment, pet insurance, maternity/paternity leave, and our discount marketplace. We also offer multiple mental health resources including free EAP counseling sessions, access to Ginger®, and Talkspace® Western Nephrology is a

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WORKPLACE and an Equal Opportunity Employer. We provide equal employment opportunity to all qualified individuals regardless of race, color, religion, sex, age, national origin, citizenship, veteran status, disability, sexual orientation, gender identity, genetic information, or any other factor protected by applicable federal, state or local law.

About Western Nephrology:

The mission of Western Nephrology is to provide the highest quality, compassionate medical care for patients with kidney disease. The physicians and staff of Western Nephrology operate with integrity and compassion and value our relationships with patients, health partners and community. We practice medicine in the most comprehensive, evidence-based approach possible. Through collaboration, integration, innovation and use of technology we maintain our position at the forefront of evolving healthcare delivery models that improve quality of life, outcomes and cost.

Our Values include:

Positive Patient Experiences:

Exceed patient expectations in every encounter

Valuing People:

Show compassion and respect for others

Continuous Learning:

Be willing to learn, grow and accept change

Accountability:

See through to completion all responsibilities and commitments

Positive Communication:

Communicate in a productive and professional manner

Professionalism:

Exhibit professionalism in communication, actions and work environment

Stewardship:

Consider the greater good over self-interest; demonstrate integrity

Job Type:

Full-time Pay:

$21.00 - $23.00 per hour

Benefits:

401(k) 401(k) matching Dental insurance Health insurance Life insurance Paid time off Vision insurance Application Question(s):

RESPONSE REQUIRED

Other than English, do you speak any languages fluently?

RESPONSE REQUIRED

Describe your referrals and prior auths experience.

RESPONSE REQUIRED

Which EMR(s) have you used recently?

Education:

High school or equivalent (Preferred)

Experience:

referrals and prior auths: 2 years (Required)

Work Location:

In person