Referral Authorization Coordinator

About the role

The Referral Authorization Coordinator works with various stakeholders to assist with the execution and finalization of referrals and authorizations.

Responsibilities

• 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.
• Processes 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.
• Communicates 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.
• Makes sure all referral reports are received and follows up in a timely manner.
• Ensures amicable interactions with coworkers and customers, including referral sources, office staff, and clinicians.
• Performs various clerical tasks such as faxing, scanning, and copying.
• Ensures work meets internal and external compliance standards.
• Meets daily, monthly, and quarterly metrics and goals set by leadership.
• Performs other related duties as needed.

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.
• Able 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.
• Supports all communications with a high level of courtesy and professional acumen.
• 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.