Authorization and Referral Coordinator - Remote

Overview

The Authorization and Referral Coordinator plays a vital role in ensuring that all necessary authorizations and referrals are obtained before the date of service, requiring close coordination with healthcare providers, insurance companies, and patients.

In Short

• Verify the need for prior authorization for scheduled services.
• Submit authorization requests with complete documentation.
• Monitor authorization status and follow up with payers.
• Confirm referral requirements based on insurance plans.
• Request and obtain referrals from primary care providers.
• Inform patients of authorization or referral requirements.
• Work closely with scheduling and clinical teams.
• Accurately document all authorization and referral activities.
• Address authorization and referral challenges.
• Escalate complex cases to supervisors.

Requirements

• Strong understanding of Medicaid, Medicare, and commercial payers' policies.
• Proficiency in EHR and practice management systems.
• Excellent verbal and written communication skills.
• Ability to resolve authorization and referral issues efficiently.
• Strong organizational skills for high-volume workflows.
• High school diploma or GED required; Associate’s degree preferred.
• Minimum 2 years of experience in healthcare administrative support.
• Certification in medical billing or coding preferred.
• Experience with payer portals and authorization tools is a plus.
• Experience with NextGen is a plus.

Benefits

• PTO Accruals Start at 3 Weeks.
• Comprehensive Medical and Dental Insurance.
• Company-Paid Optical Allowance.
• Company-Paid Routine Eye Care.
• Short-Term and Long-Term Disability Insurances.
• Educational Allowance.
• Paid Holiday Program.
• 401K with Company Match.