Healthcare Referral Coordinator with Insurance Expertise
2 weeks ago
Healthcare Referral Coordinator with Insurance Expertise
About the Role:We are seeking a detail-oriented and motivated Healthcare Referral Coordinator to join our team. As a key member of our organization, you will play a critical role in ensuring patient access and continuity of care during the annual reverification season.
Responsibilities:- Process incoming referrals from referral sources and ensure all required documentation is received in a timely manner.
- Complete intake referral checklists, enter patient demographics, insurance, and authorization details into our computer system.
- Secure authorizations and re-authorizations as required by payers and document them in the system.
- Ensure insurance verification is complete and authorization is obtained before the referral is forwarded to a pharmacist.
- Stay knowledgeable about insurance plans contracted with Amerita, including Medicare, Medicaid, and commercial insurance.
- Communicate status updates and authorization requirements to the Sales team, pharmacy staff, and other departments.
- Inform patients and caregivers about insurance coverage and payment responsibilities.
- Accurately document progress notes and maintain confidentiality of patient information.
- Manage high-volume administrative tasks typical of AR season, including benefit verification, patient outreach, and prior authorization renewals.
- Education: High School Diploma/GED required; Associate's Degree or some college preferred.
- Experience: Minimum 2 years in healthcare referral processing, with knowledge of insurance verification and pre-certification.
- Insurance Knowledge: Familiar with Medicare, Medicaid, and various commercial insurance types.
- Communication Skills: Strong verbal and written communication abilities are essential.
- Healthcare Background: Experience in pharmacy environments (particularly Specialty or Infusion), Patient Access, Intake Coordination, Scheduling, or similar roles in specialty clinics (e.g., Oncology, Cardiology, Gastroenterology) is a plus.
$48,000 - $60,000 per year, depending on experience and location.
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