Referral Coordinator

Prior authorization submission: Prepare and submit prior authorization requests to insurance companies, including necessary medical documentation, diagnosis codes, and treatment plans. Clinical review: Analyze medical records to determine if a requested service or medication aligns with medical necessity guidelines and insurance coverage. Communication with providers: Contact healthcare providers to gather additional information or clarify details regarding requested services for prior authorization. Follow-up with insurance companies: Monitor the status of pending prior authorization requests and follow up with insurance companies to obtain timely approvals. Patient education: Explain the prior authorization process to patients, including potential delays and necessary documentation. Documentation: Maintain accurate records of all prior authorization requests, including patient information, insurance details, and approval status. Billing support: Collaborate with billing staff to identify and resolve potential billing issues related to prior authorizatio Insurance verification: Accurately verify patient insurance information, including eligibility, benefits, and coverage details. #J-18808-Ljbffr