Referral Authorization Coordinator

Referral Authorization Coordinator

As a member of the revenue cycle team, the Referral Authorization Coordinator will work with various stakeholders to assist with the execution and finalization of referrals and authorizations.

Referral Authorization Coordinator Job Description:

• Utilizes a high degree of accuracy in obtaining and verifying that registration, demographic and insurance information is correct and up to date.
• Performs eligibility checks on members as necessary by telephone or electronically.
• Responsible for processing of all patient referrals for assigned cost centers.
• Obtains authorizations, follows procedures for proper authorization and processing of all referral services.
• Supports clinicians and patients in synchronized authorizations and tests taking place in different facilities.
• Communicate with facilities and clinicians to ensure follow through with referrals.
• Ensures strict confidentiality of all health records, member information and follows HIPAA guidelines.
• Completes all administrative functions related to referral activities in an efficient manner.
• Responsible for monitoring all referral reports not received and follow up in a timely manner.
• Responsible for amicable interactions with coworkers and customers, including referral sources, office staff, and clinicians.
• Various clerical work, including faxing, scanning, and copying. Ensure the work being performed meets internal and external compliance standards.
• Meet daily, monthly, and quarterly metrics and goals the leadership team sets.
• Perform other related duties as apparent and/or assigned.

Qualifications:

• 2 years' experience as a Referral Authorization Coordinator, experience with insurance verification & processes. Referral & Authorization experience is a plus.
• Proficient in Microsoft suite of products, including Outlook, Word, and Excel.
• Self-starter, able to display the highest level of integrity and respect for confidentiality.
• Ability to exercise practical judgment and sensitivity to changing needs and situations.
• High attention to detail and accuracy
• Must possess a strong sense of urgency and the ability to adapt to a changing environment.
• Excellent written and verbal communication skills. Support all communications with a high level of courtesy and professional acumen.
• Proven ability to work independently at times and within a team.
• Demonstrated ability to interact collaboratively with other departments and teams.
• Ability to multi-task, meet deadlines, and be able to succeed in a fast-paced work environment.
• Minimum High School Diploma or equivalent, 2 years' experience as a Referral Authorization Coordinator, experience performing insurance verification and prior authorizations preferred.