Referral/Pre Auth Coordinator

About the role

Here at NKC Health our mission is to empower hope and healing in every life we touch. Whether you are serving patients at a primary care clinic, specialty clinic, or in a support capacity, every team member works together to complete this mission. NKC Health Imaging for Women clinic is hiring a Referral/Pre‑Authorization Coordinator! If you’re looking for a great opportunity to impact our communities, join our NKC Health team! Our North Star: we believe in care empowered; we lead with heart, we always move forward, and we connect to more.

Responsibilities

• Under the direction of the Practice Manager or Supervisor, Patient Services, coordinate and ensure referrals and/or pre‑authorizations are managed and addressed appropriately.
• Works collaboratively with the health care team and the patient to schedule referral appointments.
• Independently completes the process for required pre‑certification and prior authorizations in a timely manner.
• Provides quality service by acting as a liaison between healthcare team, patient and specialists to coordinate outpatient referrals and obtain pre‑certifications or prior authorizations as necessary.
• Utilizes the EMR system to capture necessary information for appointments and communicate referral requirements, patient demographic information, insurance and approval information, and comments about specific patient information key to a successful appointment.
• Provides education to patients about the importance of the referral process and service provided by the physician’s office, which may include subspecialty focus.
• Coordinates efforts between providers, gathering and providing information key to appointment success.
• Communicates to physicians and other health care providers the various requirements and processes involved with medical referral authorizations for the most expedient patient appointment and successful visit.
• Completes the referral and/or preauthorization process by ensuring the specialists’ report or test results are received.
• Notifies the referring physician when a patient does not keep a referral appointment or a pre‑authorization is denied.
• Monitors incoming patient paperwork to be scanned and flags results that are to be reviewed by the physician.
• Completes FMLA, ADA and other medical paperwork as directed by the physician.

Requirements

• High school graduate or GED
• Minimum two years of experience in a physician office (preferred)
• Working knowledge of medical terminology
• Knowledge of various insurance company requirements for pre‑certification and referrals

Skills

• Basic office skills
• Critical thinking
• Detail oriented
• Able to multitask in a fast‑paced environment

Benefits

• Comprehensive benefits (Medical, Dental, Vision