US Healthcare Authorization Specialist (Senior) l Onsite l Nightshift

Job Title: Clinical Referral Specialist - Outgoing

Work set-up: Onsite and Nightshift

Site: 1880 Building, Eastwood, Libis, Quezon, City

Why join MicroSourcing?

You'll Have

• Competitive Rewards: Enjoy above-market compensation, healthcare coverage on day one, plus one or more dependents, paid time-off with cash conversion, group life insurance, and performance bonuses
• A Collaborative Spirit: Contribute to a positive and engaging work environment by participating in company-sponsored events and activities.
• Work-Life Harmony: Enjoy the balance between work and life that suits you with flexible work arrangements.
• Career Growth: Take advantage of opportunities for continuous learning and career advancement.
• Inclusive Teamwork: Be part of a team that celebrates diversity and fosters an inclusive culture.
  
  

Position Summary

The Outgoing Clinical Referral Specialist is responsible for coordinating all referrals initiated by internal providers to outside specialists and services. This includes reviewing the clinical intent, processing referral authorizations, and ensuring that patients are referred to appropriate in-network providers. The specialist plays a critical role in maintaining continuity of care and ensuring that referral workflows comply with payer guidelines.

Key Responsibilities

• Monitor the EMR and telephone encounters for internal provider-generated referrals.
• Review clinical documentation to ensure appropriate justification and completeness before processing referrals.
• Assign referrals to appropriate specialists based on insurance network status, patient preference, and provider recommendation.
• Submit referral authorization requests to insurance companies when required.
• Coordinate delivery of clinical notes, imaging, and any supporting documentation to the receiving specialist.
• Track referral status and follow up to confirm patient appointment scheduling with external offices.
• Manage communications between patients, providers, and external specialists to support continuity of care.
• Ensure timely documentation of all referral activities in the EMR system.
• Support special referrals such as DME, home health, sleep studies, and physical therapy requiring payer authorization or physician follow-up.
• Identify and escalate urgent or complex referrals to clinical leadership as necessary.
  
  

Qualifications:

• High school diploma or GED required; medical or administrative certification preferred.
• 2+ years of healthcare experience with focus on referral coordination or insurance processing.
• Deep understanding of HMO, PPO, and government payer authorization processes.
• Ability to navigate EMR systems and insurance portals efficiently.
• Strong interpersonal, multitasking, and problem-solving skills.
• Ability to work in a fast-paced environment and adapt to frequent changes in process and policy.
  
  

About MicroSourcing

With over 9,000 professionals across 13 delivery centers, MicroSourcing is the pioneer and largest offshore provider of managed services in the Philippines.

Our commitment to 100% YOU

MicroSourcing firmly believes that our company's strength lies in our people's diversity and talent. We are proud to foster an inclusive culture that embraces individuals of all races, genders, ethnicities, abilities, and backgrounds. We provide space for everyone, embracing different perspectives, and making room for opportunities for each individual to thrive.

At MicroSourcing, equality is not merely a slogan - it's our commitment. Our way of life. Here, we don't just accept your unique authentic self - we celebrate it, valuing every individual's contribution to our collective success and growth. Join us in celebrating YOU and your 100%!

For more information, visit https://www.microsourcing.com/

• Terms & conditions apply