Referral and Authorization Coordinator

Referral And Authorization Coordinator

Job Category: Clinic Support

Full-Time

On-site

Location: Ridley Park/Folsom, PA

Description

Referral and Authorization Coordinator Location: Ridley Park/Folsom, PA Organization: Premier Orthopaedics, in partnership with Philadelphia Hand to Shoulder Overview Premier Orthopaedics, in partnership with Philadelphia Hand to Shoulder, is seeking a dedicated and skilled Referral and Authorization Coordinator to join our team in Ridley Park/Folsom, PA. As two of the region's most respected providers of orthopedic and upper extremity care, we offer a collaborative, patient-focused environment that prioritizes clinical excellence, innovation, and ongoing professional development. Position Summary The Referral and Authorization Coordinator is responsible for verifying patient information, obtaining authorizations, and facilitating seamless access to care. This position supports both patients and providers by coordinating insurance requirements and ensuring accurate registration and referral processing. This is a full-time position with a standard Monday through Friday schedule.

Key Responsibilities:

• Verify and update patient registration information in the practice management system
• Obtain benefit verification and necessary authorizations (referrals, precertifications) for ambulatory visits, procedures, injections, and radiology services
• Use online verification systems and review real-time eligibility responses to ensure insurance accuracy
• Create referrals and attach them to pending visits, faxing forms to providers and insurance companies as needed
• Verify patient demographics, insurance eligibility, and coordination of benefits
• Complete chart prepping tasks to ensure smooth patient check-in processes
• Research information needed to complete registration, including coordinating with providers, ancillary staff, and patients
• Review and notify front office staff of outstanding patient balances
• Respond to provider and staff inquiries regarding referral status, care coordination, and follow-up
• Maintain satisfactory productivity and work queue goals while ensuring timely claims reimbursement
• Index referrals to existing patient accounts and create new patient accounts for non-established patients
• Identify trends and communicate potential issues to the management team

Qualifications Education: High school diploma or GED required; equivalent working knowledge considered Licenses & Certifications: None required Experience: Minimum of 23 years of experience in a healthcare environment, preferably in a referral, front desk, or billing role Must have experience with managed care insurances, requesting referrals, obtaining authorizations, and verifying insurance benefits Knowledge of insurance plan requirements for Medicaid and commercial plans Working knowledge of eligibility verification, prior authorizations, and government billing guidelines including Coordination of Benefits Advanced computer skills, including proficiency with Windows-based programs Experience with Allscripts Practice Management and EMR preferred

Compensation & Benefits Comprehensive benefits package including medical, dental, and vision plans 100% employer-paid life insurance 401(k) retirement plan with employer match Benefits begin the first of the month following hire date (for full-time employees) Generous paid sick and vacation time 7 paid holidays annually Opportunities for growth and advancement Employee referral reward program

About Premier Orthopaedics & Philadelphia Hand to Shoulder Premier Orthopaedics and Philadelphia Hand to Shoulder Center (PHSC) are leading providers of comprehensive musculoskeletal care throughout Pennsylvania, New Jersey, and Delaware. Premier Orthopaedics delivers expert treatment for orthopedic injuries, joint disease, interventional spine care, regenerative medicine, and comprehensive physical therapy services, supported by more than 150 providers across 50+ locations. Facilities include state-of-the-art MRI centers, outpatient surgery centers, physical therapy clinics, and orthopedic urgent care centers to ensure timely access to high-quality, patient-focused care. Philadelphia Hand to Shoulder Center (PHSC), a division of Premier Orthopaedics, has been nationally recognized for more than 50 years for its specialized care of the hand, wrist, elbow, arm, and shoulder. Our fellowship-trained surgeons and certified Hand and Occupational Therapists collaborate to provide seamless carefrom diagnosis and treatment to post-operative and rehabilitative recovery. With 14 convenient locations across Pennsylvania and New Jersey, PHSC offers advanced, integrated care to restore function, mobility, and quality of life for patients with upper extremity conditions.

Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.