Referral Coordinator/Authorization Specialist- Pain Clinic

Job Description

Job Description

Referral/Authorization duties:

• Verify insurance coverage for potential new patients and re-verify insurance coverage for existing patients every month
• Update patient computerized accounts with corrected insurance information.
• Determine if authorization is required for ordered services, if authorization is required, obtain authorization from insurance
• Maintain up to date information on various insurance companies and any relevant changes.
• Communicating important insurance data to appropriate staff.
• Reviews procedure requests for authorization needed based upon insurance standards while drawing upon experience and general knowledge. Reviews documentation or contacts the provider when necessary to supplement the order to prove medical necessity.
• Schedule new patients

Ensures appropriate documentation is available and complete before submitting the authorization to the insurance company to avoid repetitious submissions and denials