Referrals & Authorizations Coordinator - FT - Days - MRH

Referrals And Authorizations Coordinator

Location: Hollywood, Florida

At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience.

Summary

The Referrals And Authorizations Coordinator secures prior authorizations and primary care referrals for both professional and hospital technical services across inpatient and outpatient care, including surgeries, procedures, and specialist visits. This role facilitates timely access to care, minimizes treatment delays, and supports accurate reimbursement through payer compliance.

Responsibilities

Serves as liaison between providers, patients, and insurance companies to resolve authorization and/or referral-related issues. Verifies accuracy of referring provider to ensure data integrity and accuracy. Verifies insurance eligibility and benefits for patients, including coverage for specialty medications and services. Processes incoming and outgoing referrals from providers, ensuring appropriate documentation and approvals are in place. Obtains and documents prior authorizations and referrals for all required services. Understands and applies payer-specific guidelines, including Medicare, Medicaid, and commercial insurance requirements for both practice and hospital billing. Collaborates with clinical and scheduling teams regarding authorization status to support treatment planning and scheduling. Ensures timely follow-up on pending authorizations to prevent treatment delays.

Competencies

ACCOUNTABILITY, ACCURACY & QUALITY, CUSTOMER SERVICE, DESKTOP SOFTWARE - EHR, EFFECTIVE COMMUNICATION, HIPAA, INSURANCE VERIFICATION, MANAGE BUSINESS PRIORITIES, ORGANIZATION SKILLS, PATIENT AND FAMILY CENTERED CARE, PROBLEM SOLVING, PRODUCTIVITY, RESPONDING TO CHANGE, STANDARDS OF BEHAVIOR, TEAM WORK, VERIFY INSURANCE, WORKLOAD MANAGEMENT

Education and Certification Requirements

High School Diploma or Equivalent (Required)

Working Conditions and Physical Requirements

• Keyboard Entry = 60%
• Lifting or Carrying 0 - 25 lbs Non-Patient = 60%
• Seeing - Far = 60%

Shift: Primarily for office workers - not eligible for shift differential

Memorial Healthcare System is proud to be an equal opportunity employer committed to workplace diversity.

Memorial Healthcare System recruits, hires and promotes qualified candidates for employment opportunities without regard to race, color, age, religion, gender, sexual orientation, national origin, veteran status, disability, genetic information, or any factor prohibited by law.

We are proud to offer Veteran's Preference to former military, reservists and military spouses (including widows and widowers). You must indicate your status on your application to take advantage of this program.

Employment is subject to post offer, pre-placement assessment, including drug testing. If you need reasonable accommodation during the application process, please call View phone number on click.appcast.io (M-F, 8am-5pm) or email View email address on click.appcast.io