Referral Authorization Coordinator
About The Position
The Referral Authorization Coordinator is responsible for reviewing and verifying patients’ insurance eligibility and coverage. This role coordinates the completion of prior authorizations/referrals and submits required medical documentation to insurance companies. The coordinator ensures all insurance referral/authorization information is accurately documented in the patient’s account before their scheduled appointment. This position requires knowledge of medical terminology, ICD-10, and CPT coding to support accuracy in the authorization/referral process and involves responding to internal and external inquiries regarding authorizations/referrals. Maintaining detailed records in the Electronic Medical Records (EMR) system is also a key responsibility.
Requirements
- High School Diploma or GED, required
- 3-year medical billing office experience, required
- Computer experience, including Microsoft Excel
- Ability to multi-task and work in a fast-paced environment
- Strong analytical and problem-solving skills
- Knowledge of insurance carrier guidelines, deductibles, copays, and coinsurance
- Knowledge of medical terminology and coding (ICD-10 and CPT)
Nice To Haves
- Availity clearinghouse experience preferred
Responsibilities
- Review and verify patients’ insurance eligibility and coverage.
- Coordinate completion of prior authorizations/referrals and submit required medical documentation to insurance companies.
- Ensure all insurance referral/authorization information is documented in the patient’s account ahead of their scheduled appointment.
- Apply knowledge of medical terminology, ICD-10, and CPT coding to support accuracy in our authorization/referral process.
- Respond to internal and external inquiries regarding authorizations/referrals.
- Maintain detailed records in Electronic Medical Records (EMR) system.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
