Top 28 Referral specialist Jobs in Waldorf Md

Referral Authorization Specialist
Samaritan —Washington, DC
- $21.24 - $28.84 an hour
- Full-time
- Remote
- Heavy lifting
- HIPAA
- Mid-level
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Information & Referral Specialist (Part-Time & Full-Time)
Community Crisis Services —Hyattsville, MD
- $21.05 an hour
- 12 hour shift
- Hybrid work
- Computer literacy
- English
- High school diploma or GED
- Paid holidays
- Disability insurance
Lifeguards needed - NORTHERN VA – Multiple Locations + Flexible Hours & Referral Bonuses
Premier Pool Management —Falls Church, VA
- Up to $22 an hour
- Temporary
- CPR Certification
- Customer service
- First Aid Certification
- Flexible schedule
- Referral program
Quick Apply
Referral Coordinator
Calvert Internal Medicine Group —Prince Frederick, MD
- $17 - $20 an hour
- Full-time
- Background check
- Microsoft Excel
- Microsoft Outlook
- Disability insurance
- Health insurance
Quick Apply
Billing Agent (Contract)
Backpack Healthcare —Washington, DC
- $20 an hour
- Contract
- Remote
- Google Workspace
- Microsoft Excel
- 5 years
Quick Apply
4d
Patients Benefits Representative (Largo)
Maryland Oncology —Largo, MD
- $19.82 - $30.40 an hour
- Microsoft Excel
- HIPAA
- 3 years
8d
Medical Equipment Operations Customer Service
Rotech Healthcare Inc. —Prince Frederick, MD
- $22 - $24 an hour
- Full-time
- Background check
- Clean driving record
- Microsoft Excel
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Insurance Verification Representative
Med-Metrix —Arlington, VA
- $20 - $23 an hour
- Full-time
- Customer service
- HIPAA
- High school diploma or GED
11d
Insurance Authorization Specialist/ Medical Assistant
Lifeline Vascular Care —Colmar Manor, MD
- $23 - $30 an hour
- Online Application
- Background check
- Mid-level
- Clinic
- Health savings account
- Paid holidays
Quick Apply
Medical Documentation Specialist
Tactical Rehabilitation —Quantico, VA
- $18 - $28 an hour
- Full-time
- Military
- Medical office experience
- HIPAA
- Paid holidays
- Health insurance
Quick Apply
3d
Field Reimbursement Manager - Washington, D.C. Territory
EVERSANA —Washington, DC
- $150,000 - $165,000 a year
- Full-time
- Remote
- Hospital
- 5 years
- Mid-level
- Paid training
- Paid holidays
Quick Apply
Prior-Authorization Technician- Pharmacy
George Washington Medical Faculty Associates —Arlington, VA
- $23.46 - $30.50 an hour
- Mid-level
- High school diploma or GED
- Clinic
Quick Apply
Lead Insurance Specialist
RAYUS Radiology —Woodbridge, VA
- Full-time
- Bilingual
- Computer literacy
- HIPAA
- Paid holidays
- Disability insurance
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Health Insurance Specialist
GI group —Woodbridge, VA
- $18 - $22 an hour
- Full-time
- Spanish
- Mid-level
- High school diploma or GED
- Health insurance
- 401(k)
Quick Apply
Surgical Scheduler/Authorization Specialist
Reconstructive Surgery —Falls Church, VA
- Full-time
- Bilingual
- Background check
- Surgery
- Health insurance
- Dental insurance
Quick Apply
8d
Dental Insurance/Scheduling Coordinator
Dental Professional Associates —Washington, DC
- $20 - $24 an hour
- Full-time
- Dental office
- Mid-level
- 2 years
- Dental insurance
Quick Apply
Veterinary Assistant (Overnight Shift) - The Regional Veterinary Referral Center
PetVet Care Centers —Springfield, VA
- $23.40 - $29.70 an hour
- Overtime
- 18 years or older
- Vital signs
- High school diploma or GED
- Paid parental leave
- Health insurance
Quick Apply
8d
Veterinary Assistant (Day Shift) - The Regional Veterinary Referral Center
PetVet Care Centers —Springfield, VA
- $23.40 - $29.70 an hour
- Overtime
- 18 years or older
- Vital signs
- High school diploma or GED
- Paid parental leave
- Health insurance
Quick Apply
8d
Technician Supervisor (Rotating Shift) - The Regional Veterinary Referral Center
PetVet Care Centers —Springfield, VA
- $31 - $42 an hour
- Weekends as needed
- 18 years or older
- Mid-level
- High school diploma or GED
- Paid parental leave
- Health insurance
Quick Apply
10d
Veterinary Technician (Overnight Shift) - The Regional Veterinary Referral Center
PetVet Care Centers —Springfield, VA
- $26 - $40 an hour
- Overtime
- 18 years or older
- Anatomy knowledge
- Vital signs
- Paid parental leave
- Health insurance
Quick Apply
8d

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Referral Authorization Specialist

Samaritan -
Washington, DC

Quick Apply

Job Details

Full-time
$21.24 - $28.84 an hour

Qualifications

Customer communication
High school diploma or GED

Full Job Description

Our Mission

All of us, for each of you, every time.

Our Vision

Together, serving as the trusted regional healthcare partner.

Our Values

Listen~Love~Respect~Excel~Innovate

Samaritan is searching for a Referral & Authorization Specialist to join our team! The Referral & Authorization Specialist is responsible for coordinating and securing prior authorizations, managing outgoing referrals, and ensuring compliance with payer requirements to support timely patient care and optimal reimbursement. This role serves as a critical liaison between providers, patients, payers, and internal departments to reduce denials, prevent delays in care, and ensure accurate documentation.

This is a full-time remote position that will be required to come on-site for onboarding and equipment pick-up (2 DAYS ONLY). This is a full-time role working Monday-Friday from 8:00 AM – 4:30 PM PST.

ESSENTIAL FUNCTIONS

Prior Authorization Management

Obtain prior authorizations for hospital and clinic services, including but not limited to, outpatient procedures, imaging, surgeries, and other specialty services.

Identify the health plan(s) by confirming information provided and verifying eligibility and coverage.

Verify payer requirements for authorization, referral, and medical necessity requirements based on plan guidelines.

Submit complete and accurate authorization requests with appropriate clinical documentation.

Track authorization status and follow up with the payer at regular intervals to ensure timely approvals.

Escalate urgent or complex cases to avoid delays in patient care.

Document authorization numbers, effective dates, and limitations in the EMR.

Communicate authorization delays and denials to ordering providers and clinics.

Monitor authorization workqueues and ensure timely completion.

Referral Management

Coordinate with providers and clinics to ensure appropriate scheduling and continuity of care.

Process outgoing referrals for specialty care.

Ensure referrals meet payer and regulatory requirements (e.g., PCP referrals, network rules).

Monitor referral workqueues and ensure timely completion.

Denial Prevention & Revenue Cycle Support

Review payer policies to ensure compliance and minimize denials.

Partner with coding, billing, and clinical teams to resolve authorization-related denials.

Inform department professionals and/or providers when peer-to-peer review is necessary. Assist as needed.

Assist with retro authorization requests and appeals as needed.

Identify trends and recommend process improvements.

Communication & Assistance

Serve as the point of contact for patients regarding referral and authorization status.

Communicate clearly with providers, clinical staff, payers, and patients.

Educate patients on authorization and referral procedures and next steps.

Maintain ongoing tracking and documentation for prior authorizations and referrals to promote team awareness.

Ensure HIPAA compliance when sharing patient information with authorized care providers.

General

Participate in continuing education opportunities.

Maintains professional growth and development through seminars, workshops and professional affiliations to keep abreast of latest trends in the field of expertise.

Ensures no injuries to self or others by following safe work practices and policies. This includes, but is not limited to: security and safety, understanding of chemical Safety Data Sheets (SDS), equipment, infection control, fire, disaster, safe lifting and body mechanics.

Ensures self-compliance with organization policies and procedures, as well as labor agreements.

Ensures the interface with team members and other support groups is conducted in a courteous and efficient manner conducive to the organization's values.

Conducts self in a professional manner and ensures personal appearance meets the standards necessary to perform the job function while representing the organization.

Ensures that additional accountabilities, as may be required by management, be handled in a manner necessary to meet organizational standards.

WORK ENVIRONMENT

The professional in this position reports to the Director of Revenue Cycle. Professionals in this position will work closely with patients and other Samaritan professionals within various departments.

EDUCATION & EXPERIENCE

Education:
- High school diploma or equivalent required; Associate degree preferred.
Experience:
- Minimum of two (2) years of experience in healthcare referrals, prior authorizations, or revenue cycle required.
- Experience working in a healthcare setting providing multi-specialty support preferred.
- Certified Healthcare Access Associate (CHAA) or similar certification preferred.
- Experience with Medicare, Medicaid (including Washington Apple Health), and commercial payers.
- Understanding of medical necessity criteria and utilization management.
Skills/Competencies:
- Strong knowledge of insurance plans, payer requirements, and authorization requirements.
- Familiarity with CPT, IDC-10, and medical terminology.
- Experience with EMR systems (EPIC) and payer portals (e.g., Availity, OneHealthPort, payer websites)
- Excellent organizational and time management skills.
- Ability to manage high-volume workqueues with attention to detail.
- Effective communication and interpersonal skills.
- Demonstrates competency on equipment listed on department specific checklist.
- Strong critical thinking skills: seeks resources for direction, when necessary. Performs independent problem solving. Decision-making is logical and deliberate.
- Performs actions that demonstrate accountability. Exercises safe judgment in decision-making. Practices within legal and ethical guidelines.
- Demonstrates competency in ability to care for customers/patients across the age continuum.

PHYSICAL REQUIREMENTS

Occasional lifting, reaching, kneeling, bending, stooping, pushing and pulling.

Occasional heavy lifting (lift/carry up to 50 lbs.).

Manual dexterity and mobility.

Ability to read and understand patient charts, provider orders, tests results, etc.

Ability to communicate using verbal and/or written skills for accurate exchange of information with physicians, nurses, health care professionals, patients and/or family, and the public.

As a Samaritan professional, you will be asked to carry out the Mission, Vision, Values, and Strategy of Samaritan, personifying service and operational excellence including the creation and maintenance of the best patient, professional, physician, and student experience.

Experience

Required

2 year(s): Experience in healthcare referrals, prior authorizations, or revenue cycle

Preferred

Experience with Medicare, Medicaid (including Washington Apple Health), and commercial payers.
Experience working in a healthcare setting providing multi-specialty support

Education

Required

High School or better

Preferred

Associates or better

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.

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Refine Your Search

referral specialist jobs in waldorf md

Referral Authorization Specialist

Information & Referral Specialist (Part-Time & Full-Time)

Lifeguards needed - NORTHERN VA – Multiple Locations + Flexible Hours & Referral Bonuses

Referral Coordinator

Billing Agent (Contract)

Patients Benefits Representative (Largo)

Medical Equipment Operations Customer Service

Insurance Verification Representative

Insurance Authorization Specialist/ Medical Assistant

Medical Documentation Specialist

Field Reimbursement Manager - Washington, D.C. Territory

Prior-Authorization Technician- Pharmacy

Lead Insurance Specialist

Health Insurance Specialist

Surgical Scheduler/Authorization Specialist

Dental Insurance/Scheduling Coordinator

Veterinary Assistant (Overnight Shift) - The Regional Veterinary Referral Center

Veterinary Assistant (Day Shift) - The Regional Veterinary Referral Center

Technician Supervisor (Rotating Shift) - The Regional Veterinary Referral Center

Veterinary Technician (Overnight Shift) - The Regional Veterinary Referral Center

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