Where You’ll Work
Virginia Mason Franciscan Health has a rich history of providing exceptional healthcare, dating back to 1891. Building upon a legacy of compassionate care and innovation, our organization has evolved over the years through strategic partnerships and integrations to expand our reach and services across the Puget Sound area.Today, as Virginia Mason Franciscan Health, we remain deeply committed to healing the whole person – body, mind, and spirit – in the communities we serve. This commitment is strengthened by the diverse expertise and shared values brought together through our growth.Our dedicated providers offer a full spectrum of health care services, from routine wellness to complex disease management, all grounded in rigorous research and education. Our comprehensive network of 10 hospitals and nearly 300 care sites strategically located across the greater Puget Sound region reflects our ongoing commitment to accessibility and comprehensive care.We are proud of our pioneering medical advances and numerous awards and accreditations that reflect our dedication to excellence. When you join Virginia Mason Franciscan Health, you become part of a team that delivers top-quality, professional healthcare in modern, well-equipped facilities, and contributes to a legacy of service built on collaboration and shared purpose.
Job Summary and Responsibilities
As our Referral Specialist, you will orchestrate patient access to specialized care by expertly managing all referral and authorization processes.Every day, you will proactively obtain clearances for specialty visits, issue referrals for ancillary services (consults, imaging, labs), and secure approvals for medications, DME, home health, and other vital services.To be successful in this role, you will demonstrate meticulous attention to detail, strong organizational skills, and clear communication to ensure seamless and efficient service delivery for our patients.
- Process referrals and obtain prior authorizations for specialty care, diagnostic testing, procedures, therapies, medications, DME, and ancillary services in accordance with payer requirements.
- Verify insurance eligibility and benefits, educate patients on referral, billing, and insurance processes, and obtain cost estimates or coordinate with financial counselors as needed.
- Coordinate referral appointments and ancillary services, ensuring timely scheduling, patient follow-up, and documentation of cancellations, no-shows, and rescheduled visits.
- Communicate with patients, providers, and referring clinics regarding referral status, authorization approvals or denials, and any additional information required to support patient care.
- Maintain accurate electronic medical records by documenting referral activity, insurance information, authorizations, and scanning supporting documentation.
- Provide patients with referral instructions, pre-visit preparation materials, and coordinate educational resources and medical equipment needs to support continuity of care.
Job Requirements
Required
- Successful completion of an accredited medical terminology course(s) or equivalent on the job training, upon hire and
- one year of progressively responsible work experience that would demonstrate attainment of the requisite job knowledge/abilities.
Preferred
- Work experience in patient scheduling/registration, insurance verification, referral coordination, financial counseling or related function