Clinical Referral Specialist

Overview

Role supports Care Management by reviewing precertification files and coordinating care.

Ideal candidate has 2+ years in healthcare with strong analytical and organizational skills.

Locations

• United States

Requirements

• Degree in healthcare
• 2+ years in healthcare
• Experience with precertification
• Proficiency in Excel
• Understanding of HIPAA

Responsibilities

• Review precertification files
• Triage internal referrals
• Verify eligibility
• Use data mining tools
• Assign members to Case Managers
• Track referral activity
• Collaborate with teams

Benefits

• Medical, dental, vision, life insurance
• 401(k) with match
• HSA & FSAs
• PTO and disability leave
• EAP