Job Description Summary: Join our dedicated team at MaineGeneral Health as a Referrals Navigator! In this exciting role, you will support patients in navigating the healthcare referral process, ensuring they receive the right services at the right time. You will process referrals based on medical staff-driven algorithms and ensure that completed insurance authorizations are obtained efficiently.

Job Description:

The Work:

Referral Navigation: Utilize multiple department-specific referral algorithms to guide patients toward appropriate services, collaborating with department leadership and medical staff to optimize schedule utilization and efficiency.Liaison Role: Act as a crucial link between referral sources, patients, and medical staff, ensuring that all necessary information—such as imaging, medical records, and diagnostic testing—is accurately processed and documented.Authorization Management: Process referral authorizations and pre-certifications by working closely with clinical and administrative staff, patients, and payers. Initiate authorization requests in accordance with prior authorization protocols and applicable laws/regulations, applying your knowledge of medical terminology and the insurance landscape.Data Collection and Analysis: Gather data on referral processes and collaborate with leadership to analyze this information, identifying opportunities for improvements in patient experience and access.

You Have:

Customer Service Skills: Excellent interpersonal skills to foster positive relationships with patients and staff.Experience: At least 1 year of medical office experience preferred.Detail-Oriented: Strong organizational skills with the ability to multitask effectively.Communication Skills: Confident and effective oral and written communication abilities to convey information clearly.

Scheduled Weekly Hours: 24

Work Shift:

Job Exempt:

No

Benefits:

Supporting all aspects of our employees’ wellness – physical, emotional and financial – is a critical component of being a great place to work. With the wide range of benefits and programs available, employees have the resources they need to be well at every stage of life and plan for the future.

Physical Wellness:We offer quality dental, vision benefits and wellness programs and resources to provide employees access to resources for a healthy lifestyle and help manage health care costs.Employees have access to industry-leading leave for new parents.A generous earned time plan is offered to all employees - We believe employees need and deserve time away from work to observe holidays, be with family, go on vacation, or simply take care of themselves.

Emotional Wellness:

When life gets challenging, employees have access to our Employee Assistance Program for employees and anyone in their household.

Financial Wellness:An employee discount program is available to all employees for services provided by MaineGeneral Medical Center.Tuition Reimbursement is available to all employees to further develop skills and career.We offer eligible employees up to 2% of eligible pay in 403(b) company-matching contributions plus another 2% in the 401(a) retirement income plan.Three insurance plans are available to protect your family from the sudden loss of income in the event of your death, terminal illness or serious injury from accident.We offer both short-term and long-term disability insurance to replace a portion of your income if you become disabled and cannot work for a period of time.

Career Mobility:

Helping our employees develop their skills and grow their careers is critical to how we retain our talent and sustain our business. We do this by offering our teammates a variety of leadership-supported programs and learning and development resources for every stage of their professional development. We know that our employees are our most valuable resource – they’re how we grow our business and care for our community.

Equal Opportunity Employer M/F/Vet/Disability  Assistive technologies are available. Application assistance for those requesting reasonable accommodation to the career site is available by contacting HR at (207) 861-3440 .