Referral Specialist I – Paragon
Core
Facilitates administrative components of clinical referrals and pre-authorization for radiology and imaging exams.
Role type
Referral Specialist (Clinical Operations)
Builds
Clinical referral workflows and pre-authorization processes for imaging exams
Domain
Healthcare / Health Insurance
Required skills
Medical terminology, Benefit verification, Pre-authorization processing, Insurance coverage verification, Data entry, Multi-tasking in high-volume environments
Preferred skills
Medical terminology training, Benefit verification/authorization experience
Responsibilities
Initiates and manages clinical referrals for pre-authorization, Acts as liaison between hospitals, health plans, physicians, and patients, Reviews referrals for completeness, Verifies insurance coverage and completes pre-authorization for radiology and imaging exams, Responds to inbound calls for exam requests, Contacts physician offices for demographic data
Seniority
Entry-level, Non-Management