Authorization and Referrals Coordinator

3 weeks ago


Las Vegas, Nevada, United States Cure 4 The Kids Foundation Full time
Job Summary

We are seeking a highly skilled Authorization and Referrals Specialist to join our team at Cure 4 The Kids Foundation. This role requires a strong understanding of clinical data and knowledge to assist patients in gaining appropriate physician, hospital, radiology, medical group, and community referrals.

Key Responsibilities
  • Utilize clinical data/knowledge to assist patients in gaining appropriate referrals.
  • Process referrals and prior authorization requests in accordance with departmental guidelines.
  • Maintain updated patient files with the most current coverage information available.
  • Monitor all incoming communications directed to the department.
  • Function as a point of contact for assigned providers to answer and route questions about patient care.
Requirements
  • High school diploma or GED.
  • Two (2) years of experience in tertiary patient care setting involving interaction with a variety of medical services, contact with patients and families, and interaction with physicians.
Preferred Qualifications
  • Bachelor's degree in health-related field.
Knowledge, Skills, and Abilities
  • Ability to coordinate and oversee the simultaneous execution of multiple tasks efficiently.
  • Strong understanding of CPT, ICD-10 coding, and medical terminology.
  • Knowledge of managed care and other insurance plan benefits and coverage; including experience with the insurance authorization process.
Work Environment

This is a non-exempt, full-time position. The work environment is fast-paced and collaborative, with a focus on delivering exceptional patient care and experience.

Language Skills

Bilingual (English/Spanish) preferred, but not required.


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