PA/referral Specialist

PA/referral Specialist Henderson, NV 89052 $18

• $20 an hour
• Part-time, Full-time $18
• $20 an hour
• Part-time, Full-time Job Overview We are seeking a dynamic and detail-oriented PA/Referral Specialist to join our healthcare team.

In this vital role, you will coordinate and manage patient referrals, ensuring seamless communication between providers, insurance companies, and patients. Your expertise will help optimize patient care pathways while maintaining compliance with healthcare regulations such as HIPAA. This position offers an exciting opportunity to contribute to a high-functioning healthcare environment by facilitating efficient referral processes and supporting patient navigation through complex medical systems. Duties Act as the primary point of contact for patient referral requests, ensuring accurate and timely processing of all referrals. Verify insurance coverage and benefits through insurance verification procedures to confirm patient eligibility and authorization requirements. Collaborate with medical offices, specialists, and insurance providers to facilitate referral approvals and resolve any issues that may delay patient care. Maintain detailed and organized medical records related to referrals, including documentation of authorization, correspondence, and follow-up actions. Ensure compliance with HIPAA regulations by safeguarding patient information during all referral activities. Utilize medical coding knowledge—including CPT (Current Procedural Terminology), ICD-9, ICD-10, and ICD coding—to accurately document diagnoses and procedures associated with referrals. Support office operations by managing medical terminology, updating referral statuses, and assisting with other administrative tasks as needed. Process prior authorizations (PA) for medications, imaging, procedures, and specialty services Submit and track referrals to specialists Communicate with insurance companies to verify coverage and authorization requirements Follow up on pending authorizations to ensure timely approval Coordinate with providers to obtain necessary clinical documentation Enter referral and authorization information into the EHR system Notify patients of approval status, appointment details, or delays Work with scheduling teams to ensure patients are scheduled appropriately Maintain accurate records of all referrals and authorizations Assist front desk or clinical staff with related administrative tasks as needed Requirements Proven experience in managed care settings or medical office environments with a strong understanding of healthcare workflows. Knowledge of medical terminology, medical records management, and medical coding practices including CPT, ICD-9, ICD-10, and ICD coding systems. Familiarity with HIPAA regulations to ensure the confidentiality and security of protected health information (PHI). Experience with insurance verification processes and navigating insurance requirements for referrals. Prior dental or medical office experience is highly desirable to understand clinical workflows effectively. Excellent organizational skills with the ability to manage multiple tasks efficiently in a fast-paced environment. Strong communication skills to liaise effectively with healthcare providers, insurance companies, and patients. Join us in making a meaningful difference in patient care by streamlining referral processes! We are committed to fostering a supportive work environment where your skills can thrive while helping others access the care they need.

Pay:

$18.00

• $20.

00 per hour

Benefits:

401(k) Dental insurance Health insurance Paid time off Vision insurance

Work Location:

In person