Prior Authorization, Referral, and Medical Records Coordinator

Compensation: $20.00 - $22.00 / hour Department: Clinic Operations Location: 1658 W. Valley Blvd. Suite 120 Alhambra, CA 91803 Job Title: Prior Authorization, Referral, and Medical Records Coordinator About the Role: The Referrals, Prior Authorizations, and Medical Records Coordinator ensures timely and accurate submission, follow‑up, and approval of referrals and prior authorizations. This role requires a strong sense of urgency, attention to detail, and consistent high‑quality communication with patients, providers, and insurance companies. The coordinator supports continuity of care by ensuring all required documentation is complete and processed efficiently. What You'll Do Ensure timely, accurate submission, follow‑up, and approval of referrals, prior authorizations, and medical records while maintaining a high level of urgency and quality. Communicate effectively with patients, insurance companies, and internal teams regarding authorization status, requirements, and updates. Review requests for accuracy and completeness, ensuring all required information and supporting documentation are included prior to submission. Assist with gathering and submitting medical necessity documentation to expedite approvals and ensure compliance with payer requirements. Perform consistent and appropriate follow‑up on all pending authorizations and referrals. Collaborate with clinical and administrative departments to obtain required information for prior authorizations and to support appeals when necessary. Document all interactions with insurance companies and/or patients accurately and thoroughly in the system. Maintain detailed and accurate records of all prior authorization information, including approval dates, billing units, procedure codes, and authorization numbers within the patient profile. Proactively monitor and manage prior authorizations approaching expiration and initiate renewal processes as needed. Ensure all medical records requests are processed accurately and in compliance with organizational policies and regulatory standards. Complete all assigned duties, projects, and reports in a timely manner on a daily, weekly, or monthly basis as directed by leadership. Qualifications High school diploma or equivalent required. At least 1 year experience in prior authorization, referrals, clinical operations, or related functions. Strong verbal and written communication skills; professional and courteous manner. Proficient in Microsoft Office applications and insurance eligibility database. Excellent data entry and typing skills. You're Great for This Role If Knowledge of managed care and medical insurance plans. Knowledge of Elation EHR or similar system. Experience with medications, injections, biologics, and specialty treatment authorizations. Skills, Knowledge & Expertise High school diploma or equivalent required; associate degree or healthcare certification preferred. Prior experience and knowledge in healthcare administration, referrals, prior authorizations, or medical records strongly preferred. Knowledge of insurance plans, medical terminology, and authorization processes. Strong organizational skills with the ability to manage multiple priorities simultaneously. Excellent written and verbal communication skills. Proficiency with EHR systems and Microsoft Office applications. Attention to detail. Time management and prioritization. Customer service orientation. Problem solving and critical thinking. Accountability and reliability. Team collaboration. Join Our Team! The Referrals, Prior Authorizations, and Medical Records Coordinator is responsible for managing the end‑to‑end coordination of patient referrals, insurance prior authorizations, and medical records processing. This position plays a critical role in maintaining continuity of care by ensuring that all required documentation is complete, accurate, and processed efficiently within established timelines. #J-18808-Ljbffr Astrana Health