Referral Authorization Coordinator

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.