Referral & Authorization Coordinator

Referral & Authorization Coordinator

We are a wonderful, growing organization seeking an experienced Referral & Prior Authorization Coordinator to join our team and manage incoming referrals, appointment scheduling, insurance prior authorizations, and surgical financial estimates for our specialty practice.

The ideal candidate is highly organized, detail-oriented, personable, and comfortable working in a fast-paced medical office environment. This position requires excellent communication skills and the ability to effectively manage multiple priorities while providing exceptional service to patients, referring providers, and insurance companies.

Duties include, but are not limited to:

• Managing all incoming referrals from primary care physicians and other specialty practices
• Reviewing referrals and medical records for completeness and ensuring patients are schedule appropriately
• Scheduling appointments for seven physicians, three physician assistants, one nurse practitioner, and five audiologists
• Obtaining and coordinating insurance prior authorizations for diagnostic testing, procedures, and surgical services
• Verifying insurance benefits and coverage requirements as needed
• Communicating with insurance companies regarding authorization requirements, benefits, and coverage
• Preparing and coordinating financial estimates for patients undergoing surgery , including reviewing insurance benefits, deductibles, coinsurance, and estimated patient responsibility
• Communicating financial estimates and insurance information clearly and professionally to patients
• Following up on pending authorizations and ensuring required documentation is submitted promptly
• Maintaining accurate referral, authorization, and patient financial information in the electronic health record
• Performing general clerical duties including faxing, scanning, printing, data entry, and scheduling
• Providing excellent customer service to patients and referring providers
• Other administrative duties as assigned

Qualifications:

• Prior experience working in a medical office is required
• Prior experience with insurance prior authorizations is required
• Experience preparing surgical or procedure financial estimates is strongly preferred, but not required
• Knowledge of medical insurance benefits, deductibles, coinsurance, copays, and prior authorization requirements
• Experience working with Electronic Health Records (EHRs) is required
• Excellent phone etiquette and communication skills
• Strong organizational skills with exceptional attention to detail
• Ability to multitask, prioritize, and work efficiently in a high-volume environment
• Ability to communicate complex insurance and financial information clearly and professionally
• Pleasant, professional demeanor and an outgoing personality
• Excellent customer service skills
• Strong computer skills and ability to learn new software systems quickly
• Ability to work independently while also being a strong team player

Competitive Pay & Benefits

• Medical, Dental, Vision Insurance
• Life Insurance
• 401(k) & Profit Sharing Plan
• Paid Time Off

Job Type: Full-time

Ability to Relocate:

• Denver, CO 80210: Relocate before starting work (Required)

Work Location:

• In person