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Referrals Specialist

Nira Medical· Clinical
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Tampa, FloridaFull-timePosted 4d ago

About the role

Join one of the Tampa Bay area’s leading outpatient MS and Neuromuscular programs. Physician-led practice focused on access, referrals, and coordination of care for neurology patients.

Responsibilities

  • Request and obtain PCP referrals for patients prior to scheduled appointments for both the Clearwater and Lutz neurology offices.
  • Submit, track, and follow up on HMO authorization requests for new and established patients until a determination is received.
  • Monitor upcoming appointments to identify referral and authorization requirements in advance and prevent scheduling or billing delays.
  • Communicate with PCP offices, insurance companies, and patients to resolve missing, expired, or denied referrals and authorizations.
  • Enter and track all referral and authorization activity in the clinic’s referral tracking spreadsheet and the EMR, including approval dates, visit limits, and expiration dates.
  • Notify the front desk, scheduling team, and clinical staff when authorizations are pending, approved, or require action.
  • Escalate authorization denials and complex payer issues to the appropriate leadership or central support team members.
  • Verify patient insurance eligibility and benefits prior to scheduled appointments.
  • Confirm that patient insurance is accepted and identify referral or authorization requirements by plan.
  • Use payer portals such as Availity and individual insurance websites to confirm eligibility and authorization requirements.
  • Contact patients and/or insurance companies as needed to resolve coverage questions, and communicate coverage information clearly to patients.
  • Assist with scheduling new patient appointments for faxed referrals received through the EMR and for self-referred patients, as needed.
  • Contact patients to collect required demographic, insurance, and referral information and enter data accurately into the medical record.
  • Select appropriate appointment types, dates, and times based on clinic guidelines.
  • Serve as backup receptionist at the Lutz office when the receptionist is unavailable, including: checking in/out patients, verifying IDs/insurance, collecting payments, printing materials, and scheduling follow-ups.
  • Answering incoming phone calls related to administrative and scheduling questions.
  • Managing patient voicemails, front desk inbox, and EMR inbox, and responding to patient portal messages.
  • Perform additional duties as assigned to support patient access, clinic efficiency, and patient satisfaction.

Qualifications

  • High school diploma or equivalent required; additional education or certification preferred.
  • Prior experience in a medical office setting, preferably in referral coordination, prior authorization, insurance verification, or patient access.
  • Working knowledge of HMO and PPO plan structures, referral requirements, and authorization processes.
  • Knowledge of new patient and follow-up CPT codes, including how they relate to referral and authorization requirements.
  • Experience with an EMR system and payer portals such as Availity preferred.
  • Strong attention to detail and organizational skills, with the ability to track multiple open referrals and authorizations and follow them through to completion.
  • Excellent written and verbal communication skills, with a professional and courteous phone manner.
  • Ability to work independently, manage competing priorities, and meet deadlines in a fast-paced environment.
  • Proficiency with spreadsheets and common office software.
  • Neurology or specialty care experience, particularly with MS, neuromuscular, or infusion therapy patients, is a plus.

Skills

Required:Referral coordinationPrior authorizationInsurance verification
Nice to have:EMR systemsPayer portals (Availity)
Last updated Oct 22, 2026. Interested? Apply on the company site.

About Nira Medical

Building the future of neurological care

Making life-changing neurological treatment accessible to patients by empowering neurologists to provide world-class care.

neurological carephysician practiceneurologyclinical practiceneuroscience
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