Referral Specialist - PediatricsÂ

Referral Specialist - Pediatrics

Job Summary

Occupation : Referral Specialist

Specialty : Pediatrics

Salary : $22.44–$35.90 / hour

Working Hours : 40 hours / week

Shifts : Day

On-Call : No

Degree Required : High school diploma or equivalent

Position Type : Full Time

Work Environment : Hospital Clinic

Location : 93555, Ridgecrest, California, United States

Visa Sponsorship : No

Job Description

We’re looking for a Referral Specialist to support the RRH Pediatrics Department with managing referrals and prior authorization requests. In this role, you’ll help ensure timely, accurate processing of pediatric patient referrals, assist in navigating insurance requirements, and support families and clinical teams throughout the referral process.

This position is ideal for someone who thrives in a fast-paced environment, excels in customer service, and is confident in handling insurance documentation and communication. If you're detail-oriented, proactive, and enjoy supporting both patients and providers, this could be the right fit for you.

Key Responsibilities

Receive, process, and document referrals and prior authorization requests

Obtain and verify insurance pre-authorizations and re-authorizations

Maintain compliance with documentation standards and insurance requirements

Collaborate with pediatric clinical teams and Patient Financial Services to support the referral workflow

Communicate with patients, families, providers, and insurance companies

Track and adapt to ongoing insurance and referral policy changes

Support the overall improvement of referral processes and customer service

Collaborative Teamwork

This role involves working closely with our pediatric and administrative teams to ensure timely patient referrals and contribute to a supportive and collaborative work environment.

Qualifications

High school diploma or equivalent required

Two years of college in a related field or business school preferred

Medical Assistant, LVN, or RN background highly desired

Minimum of three years’ experience in medical insurance or related field

Familiarity with prior authorization and referral processes for diagnostics, therapies, and procedures

Computer proficiency (Microsoft Word, Excel)

Typing speed of 25 WPM without errors

Excellent communication skills in English

Demonstrated commitment to Service Excellence

Benefits You'll Enjoy

Dental

Vision and 403B

Life Insurance

Flex Spending Accounts

AFLAC Supplemental Plans

Employee Assistance Program

Gym Membership Reimbursement

Tuition Reimbursement

Paid Time Off

Welcome To RRH

Established for 60 years, RRH is a non-profit, full-service Hospital with 25 inpatient beds, a 99-bed skilled nursing facility, clinics, and other outpatient services. RRH has state-of-the-art facilities and offers multi-specialty healthcare, view Treatment & Care. In 2023, it was honored by the American Medical Association for promoting the well-being of healthcare workers and has an established physician well-being program.

Our mission is to be the partner of choice for the healthcare needs of our community. Our purpose is to care for our community’s health and the well-being of those who care for them.

About Ridgecrest

Ridgecrest is a family-friendly community of 30,000 in the desert of central Southern California, far from the traffic and commotion of LA. Affordable and safe, it's been voted as the best place to live in Kern County by Niche. Home of the China Lake Naval Air Weapons Station, it is near the Sierra Mountains and full of natural wonders, outdoor activities, and sunshine. Our hospital is close to Mammoth Ski Area, Mount Whitney, Sequoia National Forest and Death Valley. Learn more About Ridgecrest and the Outdoor Activities around it.

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