Referral Authorization Coordinator

Referral Authorization Coordinator

Location: Landis Lakes office - Hybrid

Reports To: Patient Engagement Manager

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

Family Allergy & Asthma