Referral and Authorization Coordinator
About The Position
Premier Orthopaedics, in partnership with Philadelphia Hand to Shoulder, is seeking a dedicated and skilled Referral and Authorization Coordinator to join our team in Ridley Park/Folsom, PA . As two of the region’s most respected providers of orthopedic and upper extremity care, we offer a collaborative, patient-focused environment that prioritizes clinical excellence, innovation, and ongoing professional development. The Referral and Authorization Coordinator is responsible for verifying patient information, obtaining authorizations, and facilitating seamless access to care. This position supports both patients and providers by coordinating insurance requirements and ensuring accurate registration and referral processing. This is a full-time position with a standard Monday through Friday schedule.
Requirements
- High school diploma or GED required; equivalent working knowledge considered
- Minimum of 2–3 years of experience in a healthcare environment, preferably in a referral, front desk, or billing role
- Must have experience with managed care insurances, requesting referrals, obtaining authorizations, and verifying insurance benefits
- Knowledge of insurance plan requirements for Medicaid and commercial plans
- Working knowledge of eligibility verification, prior authorizations, and government billing guidelines including Coordination of Benefits
- Advanced computer skills, including proficiency with Windows-based programs
- Experience with Allscripts Practice Management and EMR preferred
Nice To Haves
- Experience with Allscripts Practice Management and EMR preferred
Responsibilities
- Verify and update patient registration information in the practice management system
- Obtain benefit verification and necessary authorizations (referrals, precertifications) for ambulatory visits, procedures, injections, and radiology services
- Use online verification systems and review real-time eligibility responses to ensure insurance accuracy
- Create referrals and attach them to pending visits, faxing forms to providers and insurance companies as needed
- Verify patient demographics, insurance eligibility, and coordination of benefits
- Complete chart prepping tasks to ensure smooth patient check-in processes
- Research information needed to complete registration, including coordinating with providers, ancillary staff, and patients
- Review and notify front office staff of outstanding patient balances
- Respond to provider and staff inquiries regarding referral status, care coordination, and follow-up
- Maintain satisfactory productivity and work queue goals while ensuring timely claims reimbursement
- Index referrals to existing patient accounts and create new patient accounts for non-established patients
- Identify trends and communicate potential issues to the management team
Benefits
- Comprehensive benefits package including medical, dental, and vision plans
- 100% employer-paid life insurance
- 401(k) retirement plan with employer match
- Benefits begin the first of the month following hire date (for full-time employees)
- Generous paid sick and vacation time
- 7 paid holidays annually
- Opportunities for growth and advancement
- Employee referral reward program
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
