Referral Authorization Specialist

Tryon Medical Partners
Charlotte, NC

Referral Authorization Specialist

General Job Summary: The Referral Authorization Specialist will be responsible for managing referrals from the practice to other facilities or service providers and incoming action referrals from other service providers.

(This is a full time position that will support the TPC at SouthPark, Monday to Friday 8 am to 5 pm)

Primary Job Responsibilities:
  • Complete all referrals for the clinics and ensure they are processed effectively, making sure they are sent to the correct department.
  • Responsible for prioritizing Stat Referral Authorizations.
  • Follow up on sent referrals.
  • Review patient benefits and eligibility to communicate with clinician and clinical staff pertaining to authorization.
  • Keep the system up to date with any changes in information.
  • Manage referral status to ensure clinics have all updated and current information.
  • Completes referrals for patients and coordinates with referring and receiving practices and/or departments.
  • Obtains and maintain prior authorizations for diagnostic and ancillary testing.
  • Handle sensitive information in a confidential manner.
  • All other duties as assigned.


Clinic Support responsibilities include:

  • Compiles patients’ health information including patient symptoms and medical history, exam results, X-ray reports, lab tests, diagnoses, and treatment plans.
    • Ensures all related reports, labs and demographics are sent to the outside facility prior to their appointment.
    • Reviews to ensure all forms are completed, properly identified, and signed and that all necessary information in the EHR.
  • Communicates as needed with physicians and other health care professionals to clarify diagnoses or obtain additional information.
  • Obtains lab/X-ray reports, hospital notes, referral information, etc.;
  • Verifies insurance coverage and patient demographics;
  • Updates charts to ensure that information is complete and filed appropriately.
  • Ensures timely delivery of outside mail and communication to the physician

Requirements:

Education, Experience and Certifications:
  • High School Diploma or GED required.
  • Minimum 2 years’ experience in a health coordination role.
  • Demonstrated understanding of industry guidelines and best practices.
  • Thorough understanding of insurance coverage and Medical Necessity policies.
  • Customer service experience required.
  • Knowledge of medical records software preferred.
  • Completion of Hepatitis B Vaccine and Flu Vaccine Form will be required. Candidate may decline vaccination through declination form or may provide record of vaccination from previous employer.
  • Completion of TB test will be required.

Physical Requirements:

  • Work consistently requires walking, standing, sitting, lifting, reaching, stooping, bending, pushing, and pulling.
  • Must be able to lift and support weight of 35 pounds
  • Ability to concentrate on details.
  • Use of computer for long periods of time.

Posted 2026-01-23

Recommended Jobs

Multi-Family RE Portfolio Manager (Charlotte, NC))

Royal Bank of Canada
Charlotte, NC

Job Description Multi-Family RE Portfolio Manager – Charlotte, NC What is the opportunity? RBC Capital Markets – RBC Community Investments ( part of the Royal Bank of Canada (RBC) firm, is …

View Details
Posted 2025-10-31

Electrical Engineering Intern (Energy/Power) - Summer 2026

Cary, NC

Energy At Jacobs, we're challenging today to reinvent tomorrow by solving the world's most critical problems for th…

View Details
Posted 2026-03-18

GIS Specialist

Delta Oaks Group
Raleigh, NC

Benefits: ~401(k) ~401(k) matching ~ Bonus based on performance ~ Competitive salary ~ Dental insurance ~ Health insurance ~ Opportunity for advancement ~ Paid time off ~ Vision insu…

View Details
Posted 2026-02-19

Freelance In-Person Event Specialist - Raleigh, NC

Visit.org
Raleigh, NC

Visit.org is looking for an experienced, responsible, and driven Freelance Event Specialist, Raleigh, NC to help us manage the logistics of an upcoming in-person event, which will be held live at a…

View Details
Posted 2026-02-16

HVAC Service Technician

P.E.A.C.H. Teams
Wilson, NC

APPLY TODAY AND JOIN OUR TEAM!!! Duties/Responsibilities: ~ MUST HAVE 2+ years of residential HVAC experience. Installs new HVAC units in residential, commercial, or industrial buildi…

View Details
Posted 2026-01-15

Home Care Aide

EULA Home Care Agency
Charlotte, NC

Job Description Job Description Benefits: Company parties Flexible schedule Benefits/Perks Flexible Scheduling Competitive Compensation Careers Advancement We are looking for…

View Details
Posted 2026-03-17

Class A Southeast Regional Driver

Four Brothers Trucking
Lumberton, NC

Dedicated CDL-A Driver – Weekly Home Time Position: Dedicated CDL-A Truck Driver Pay: Average weekly $1,200 – $1,500 Job Highlights Consistent schedule with predictable routes Weekly ho…

View Details
Posted 2026-01-14

Food Service Worker - Shaw University

Thompson Hospitality Corporation
Raleigh, NC

Overview: Are you passionate about food and great service? Our campus dining facility is looking for dedicated, friendly, and hardworking individuals to join us as Food Service Workers — an essenti…

View Details
Posted 2025-12-29