Referral Specialist I

Anticipated End Date: 2026-11-07 Position Title: Referral Specialist I Job Description: Referral Specialist I Location: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Hours: Monday through Friday; candidates will be assigned a shift between 7 AM and 8 PM Central time. The Referral Specialist I is responsible for providing support to a clinical team in order to facilitate the administrative components of clinical referrals. How you will make an impact: - Initiates and manages clinical referrals for pre-authorization. - Acts as a liaison between hospital, health plans, physicians, patients, vendors and other referral sources. - Reviews referrals for completeness and follows up for additional information if necessary. - Assigns escalated referrals to staff as appropriate. - Verifies insurance coverage and completes pre-authorization process for radiology and other imaging exams (CT, MRI, MRA, PET, et.) following established process and procedures. - Responds to inbound calls initiating exam requests following established processes, meets quality and production standards. - Contacts physician offices as needed to obtain demographic information or related data. - Enters referrals, documents communications and actions in system. - Associates in this role are expected to have the ability to multi-task, including handling calls, texts, facsimiles, and electronic queues, while simultaneously taking notes and speaking to customers. Additional expectations to include but not limited to: - Proficient in maintaining focus during extended periods of sitting and handling multiple tasks in a fast-paced, high-pressure environment; - strong verbal and written communication skills, both with virtual and in-person interactions; - attentive to details, critical thinker, and a problem-solver; - demonstrates empathy and persistence to resolve caller issues completely; - comfort and proficiency with digital tools and platforms to enhance productivity and minimize manual efforts. Associates in this role will have a structured work schedule with occasional overtime or flexibility based on business needs, including the ability to work from the office as necessary. - Performs other duties as assigned. Minimum Requirements: - Requires HS diploma or GED and a minimum of 1 year of experience in a high-volume, interactive customer service or call center environment; or any combination of education and experience which would provide an equivalent background. Preferred Skills, Capabilities and Experiences: - Knowledge of medical terminology strongly preferred.