Responsible for coordinating referrals and prior authorizations, ensuring compliance with enterprise standards and referral guidelines. Serves as a liaison between patients, referring offices, specialists, and clinical teams to support appointment scheduling, care coordination, and follow-up.
Manages incoming and outgoing referrals, tracks patient compliance, documents communication in the electronic health record, and obtains insurance authorizations for visits, testing, and specialty services. Handles complex prior authorization requests, communicates with insurers, coordinates peer-to-peer reviews, and helps draft letters of medical necessity when needed.
Supports urgent and routine referral processing, including ED and urgent care orders, ancillary testing, external records collection, and electronic transfer of care information.
High school diploma or equivalent required.
At least 2 years of relevant experience required, or an equivalent combination of education and experience.
Preferred:
- Medical terminology knowledge
- Experience with surgical or appointment scheduling software
- Experience with electronic medical records
Required skills:
- Strong customer relations skills
- Knowledge of ICD and CPT coding terminology
- Ability to manage referrals, prior authorizations, and patient scheduling workflows
Location
New York, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
3 weeks ago