Job Description

As a Referrals Specialist, you will assist in monitoring utilization of medical services to assure cost effective use of medical resources through processing prior authorizations.

JOB RESPONSIBILITIES:

• Initiate authorization requests for outpatient and inpatient services in accordance with the prior authorization list.
• Route to appropriate staff when needed.
• Verify eligibility and benefits.
• Answer phone queues and process faxes within established standards.
• Data enters authorizations into the system.

EDUCATION/EXPERIENCE:

• High school diploma or equivalent.
• Knowledge of medical terminology preferred.
• Call center/Medi-Cal experience strongly preferred.
• 2+ years of experience.