SPECIALIST, AUTHORIZATION & REFERRAL

Authorization Manager

The Authorization & Referral Specialist is responsible for coordinating all aspects of the prior authorization and referral process. This includes insurance and benefit verification, obtaining authorizations for internal services and referrals to outside providers, gathering necessary clinical documentation to meet payer requirements, and ensuring timely processing to support continuity of care and reimbursement.

This position works collaboratively with providers, referral coordinators, insurance companies, and patients to ensure that all services, whether performed within the organization or by external specialists, meet payer authorization requirements.

The specialist contributes to the development and maintenance of standardized workflows for both prior authorizations and referrals across the organization and is expected to participate in cross-training initiatives to support departmental flexibility and coverage.