Referral Authorization Coordinator

Deer Oaks•San Antonio, TX

10d

About The Position

The Referral Authorization Coordinator is responsible for obtaining and verifying registration, demographic, and insurance information with a high degree of accuracy. This role involves performing eligibility checks for members via telephone or electronically, processing all patient referrals for assigned cost centers, and obtaining necessary authorizations. The coordinator must follow proper procedures for authorization and processing of all referral services, and support clinicians and patients with synchronized authorizations and tests across different facilities. Effective communication with facilities and clinicians is crucial to ensure follow-through with referrals. The position requires strict adherence to confidentiality of health records and member information, following HIPAA guidelines. Additionally, the role involves completing all administrative functions related to referral activities efficiently, monitoring and following up on unreceived referral reports, and maintaining amicable interactions with coworkers and customers. Clerical tasks such as faxing, scanning, and copying are also part of the duties. The coordinator must ensure work meets internal and external compliance standards and meets daily, monthly, and quarterly metrics and goals. Other related duties may be assigned.

Requirements

2 years' experience as a Referral Authorization Coordinator
Experience with insurance verification & processes
Proficient in Microsoft suite of products, including Outlook, Word, and Excel.
Self-starter, able to display the highest level of integrity and respect for confidentiality.
Ability to exercise practical judgment and sensitivity to changing needs and situations.
High attention to detail and accuracy
Must possess a strong sense of urgency and the ability to adapt to a changing environment.
Excellent written and verbal communication skills.
Support all communications with a high level of courtesy and professional acumen.
Proven ability to work independently at times and within a team.
Demonstrated ability to interact collaboratively with other departments and teams.
Ability to multi-task, meet deadlines, and be able to succeed in a fast-paced work environment.
Minimum High School Diploma or equivalent

Nice To Haves

Referral & Authorization experience is a plus.
Experience performing insurance verification and prior authorizations preferred.

Responsibilities

Obtain and verify registration, demographic, and insurance information with high accuracy.
Perform eligibility checks on members via telephone or electronically.
Process all patient referrals for assigned cost centers.
Obtain authorizations and follow procedures for proper authorization and processing of referral services.
Support clinicians and patients in synchronized authorizations and tests at different facilities.
Communicate with facilities and clinicians to ensure follow-through with referrals.
Ensure strict confidentiality of all health records and member information, following HIPAA guidelines.
Complete all administrative functions related to referral activities efficiently.
Monitor all referral reports not received and follow up in a timely manner.
Maintain amicable interactions with coworkers and customers, including referral sources, office staff, and clinicians.
Perform various clerical work, including faxing, scanning, and copying.
Ensure work meets internal and external compliance standards.
Meet daily, monthly, and quarterly metrics and goals.
Perform other related duties as apparent and/or assigned.