Referral Authorization Specialist

UP Health System - Portage

Referral Authorization Specialist

Job Type: Full Time

Your experience matters

Up Health System- Portage part of Lifepoint Health, a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. By joining our team, you're embracing a vital mission dedicated to making communities healthier ®. Join us on this meaningful journey where your skills, compassion and dedication will make a remarkable difference in the lives of those we serve.

How you'll contribute

A Referral Authorization Specialist who excels in this role:

• Completes pre-authorizations for all diagnostic testing, therapy, surgical and specialty care appointments according to insurance requirements within 3 days of issuance.
• Notifies patient when referral is approved and notifies Provider if denied or if a second opinion or additional information is required.
• All communication with patient, nurse, and/or Provider will be documented in the clinic EMR.
• Updates to referrals will be made in the EMR each time communication is had with patient, insurance provider, nurse, or Provider.
• Maintains up-to-date knowledge of all health care plans and interprets and communicates plan policies and procedures to employees, physicians and (patients) when they have changed.
• Identifies and attempts to resolves patient’s barriers to specialty care, including assisting with scheduling appointments and helping to coordinate with specialist offices.
• Assists in tracking high-priority referrals to ensure patients in high-risk categories receive necessary follow up care.
• Under the supervision of physician or nurse, assists with performing patient assessments and treatments.
• Performs administrative or clerical duties as assigned, including filing, reception, scheduling, data entry, and patient registration.

Why join us

We believe that investing in our employees is the first step to providing excellent patient care. In addition to your base compensation, this position also offers:

• Comprehensive Benefits: Multiple levels of medical, dental and vision coverage for full-time and part-time employees.
• Financial Protection & PTO: Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave and paid time off.
• Financial & Career Growth: Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match.
• Employee Well-being: Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs).
• Professional Development: Ongoing learning and career advancement opportunities.

What we're looking for

Referral Authorization Specialist :

• Education: High School Diploma or Equivalent Required. Associates Degree preferred.

• Preferred Minimum Work Experience: 2 years Medical Office experience Preferred. Experience with Medical Referrals Preferred

• Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision.

  • Must be able to work in a stressful environment and take appropriate action.

More about UP Health System – Portage

Your Regional Medical Center

UP Health System – Portage has been serving Michigan's Western Upper Peninsula since 1896. It supports a multi-specialty medical community with over 40 physicians, and more than a dozen allied health professionals. The main campus features a 36-bed hospital, accredited as a chest pain center by the Society of Cardiovascular Patient Care (SCPC). UP Health System – Portage was the first in the state to achieve Level III ACC (American College of Cardiology) verification as a trauma center.

Additional services include dedicated physician hospitalists, cardiopulmonary services, elective and emergency orthopedics, women’s health, general surgery, hematology and oncology, internal medicine, sports medicine and rehabilitation and sports medicine, x-ray and diagnostics (including MRI, mobile PET scan, 64-slice CT scanner, nuclear imaging, and 3D mammography), an advanced wound care center, a sleep lab, two Express Care walk-in clinics, a regional dialysis unit, pharmacy services, laboratory services, home care, and a 60-bed senior living community.

UP Health System- Portage
Our Community

With small communities and big ideas, Michigan's Upper Peninsula is the perfect place for people to explore their many interests. Visit the art galleries, and museums, walk along the beaches of Lake Superior, hike, bike, and explore the beautiful nature trails. Wrap yourself up in a blanket of bright stars, clean air and open water.

Hancock is a community that brings together small-town values, rich history and a four-season wonderland for outdoor enthusiasts — without long commute times or congested highways. The Keweenaw is home to two universities — Michigan Technological University and Finlandia University. The community benefits from the diversity, culture and high standards of living contributed to our small town. We often call the Keweenaw the "Copper Country" because of the amount of natural "float" copper found in the area. In fact, at 90% pure, much of the copper is the purest copper in the world.

Welcome, to the Keweenaw Peninsula!

EEOC Statement

UP Health- Portage is an Equal Opportunity Employer. Marquette General Hospital is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment."