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Referral and prior authorization representative iii

United States of America, Rochester 19.62 - 26.49 USD / Hour · Job Posted February 20, 2026
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Job Description

As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive.

Job Responsibility

  • Serves as the patient referral and prior authorization specialist, with oversight of data and compliance to enterprise standards and referral and prior authorization guidelines
  • Communicates regularly with patients, families, clinical and non-clinical staff, identifying barriers to appointment compliance, insurance company barriers, and tracking all assistance provided
  • Accountable for planning, execution, appeals, and efficient follow-through on all aspects of the process, which has a direct, multifaceted impact (quality, financial, patient satisfaction, etc.) on patient scheduling, treatment, care, and follow-up
  • Adheres to approved protocols for working referrals and prior authorizations
  • Makes decisions that are guided by protocols and practices requiring some interpretation
  • maintains an expert-level understanding of the department/division
  • May train new staff members

Requirements

  • High School Diploma required
  • Minimum of two years of relevant experience required, or an equivalent combination of education and experience
  • Medical Terminology, experiences with appointment scheduling software and electronic medical records preferred
  • Demonstrated customer relations skills required

Nice to have

Medical Terminology, experiences with appointment scheduling software and electronic medical records

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