Referral Authorization Coordinator

Description

Job Title: Referral Authorization Coordinator

Location: Landis Lakes office -Hybrid

Reports To: Patient Engagement Manager

Department: Scheduling and Registration

Travel Required: No

Summary of Duties and 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.

Education, Prior Work Experience, Special Skill and Knowledge 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)

-Availity clearinghouse experience preferred