Referral Authorization Coordinator

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 all patient referrals for assigned cost centers, obtaining authorizations, and following procedures for proper authorization and processing of all referral services. Supports clinicians and patients in synchronized authorizations and tests taking place in different facilities, and communicates with facilities and clinicians to ensure follow‑through with referrals. Ensures strict confidentiality of all health records and member information in compliance with HIPAA, completes all administrative functions related to referral activities efficiently, monitors referral reports and follows up promptly, and maintains amicable interactions with coworkers, customers, referral sources, office staff, and clinicians. Performs various clerical work, meets internal and external compliance standards, and achieves daily, monthly, and quarterly metrics set by leadership while performing other related duties as assigned.

Responsibilities

• Utilize a high degree of accuracy in obtaining and verifying registration, demographic, and insurance information.
• Perform eligibility checks on members by telephone or electronically.
• Process all patient referrals for assigned cost centers.
• Obtain authorizations and follow procedures for proper authorization and processing of referral services.
• Support clinicians and patients in synchronized authorizations and tests across different facilities.
• Communicate with facilities and clinicians to ensure follow‑through with referrals.
• Ensure strict confidentiality of health records and member information in accordance with HIPAA guidelines.
• Complete all administrative functions related to referral activities efficiently.
• Monitor referral reports that have not been received and follow up in a timely manner.
• Maintain amicable interactions with coworkers, customers, referral sources, office staff, and clinicians.
• Perform various clerical tasks, including faxing, scanning, and copying.
• Ensure work meets internal and external compliance standards.
• Meet daily, monthly, and quarterly metrics and goals set by the leadership team.
• Perform other related duties as apparent and/or assigned.

Qualifications

• 2 years' experience as a Referral Authorization Coordinator, with experience in insurance verification and processes.
• Referral & Authorization experience is a plus.
• Proficient in Microsoft Office suite (Outlook, Word, Excel).
• Self‑starter with 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.
• Strong sense of urgency and ability to adapt to a changing environment.
• Excellent written and verbal communication skills; courteous and professional in all communications.
• Proven ability to work independently and within a team.
• Demonstrated ability to interact collaboratively with other departments and teams.
• Ability to multi‑task, meet deadlines, and 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.