Referral and Authorization Coordinator

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.

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
• Create new patient accounts for non-established patients
• Index referrals to existing patient accounts
• 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
• 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
• 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 2–3 years of experience in a healthcare environment, preferably in a referral, front desk, or billing role
• Knowledge: Must have experience with managed care insurances, requesting referrals, obtaining authorizations, and verifying insurance benefits
• Knowledge: Working knowledge of eligibility verification, prior authorizations, and government billing guidelines including Coordination of Benefits
• Skills: Advanced computer skills, including proficiency with Windows-based programs
• Experience: Experience with Allscripts Practice Management and EMR preferred

About Premier Orthopaedics & Philadelphia Hand To Shoulder

Premier Orthopaedics, in partnership with Philadelphia Hand to Shoulder, is a leading provider 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 170 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 care—from diagnosis and treatment to post-operative and rehabilitative recovery. With 10+ 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.