Referral / Authorization Coordinator

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🔥 3 hours ago

🤠 Texas – Remote

🤠 Texas – Remote

💵 $25 - $35 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

✨ Referral Coordinator

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Health Services of North Texas

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 1988

🏥 Healthcare

🤝 Non-profit

💰 Grant on 2024-08

Healthcare • Non-profit

Health Services of North Texas (HSNT) is a Community Health Center that has served North Texans for over 37 years, providing primary care and supportive health services to about 20,000 patients annually. HSNT offers a broad range of services including primary care, pediatrics, women’s health and OB/GYN, behavioral health, infectious disease care (HIV, Hepatitis C, PrEP), senior care, on-site lab testing, immunizations, and prescription assistance. As a federally supported community health center, HSNT accepts Medicaid, Medicare, private insurance, and provides a sliding fee scale to ensure access for uninsured patients; it receives HRSA support and FTCA coverage under federal program provisions.

📋 Description

• Review, enter, and process incoming referral requests and prior authorization submissions quickly and accurately according to payer requirements. • Verify insurance coverage and benefits using online portals and phone verification to confirm eligibility, in‑network providers, and authorization requirements. • Collaborate with providers and clinic staff to obtain necessary clinical notes, orders, and supporting documentation needed for approvals. • Utilize medical terminology, CPT codes, and ICD‑9/ICD‑10 coding to support accurate and complete referral and authorization requests. • Maintain strict compliance with HIPAA and organizational privacy policies when handling patient information throughout the referral process. • Track, monitor, and document all referral and authorization activities in the electronic health record (EHR) and other tracking tools to ensure audit readiness. • Follow up with insurance carriers to check status, appeal denials when appropriate, and clarify any missing or incorrect information. • Communicate clearly with providers, clinic staff, and patients about referral status, required steps, and any issues affecting scheduling or approval. • Work closely with billing and front‑office teams to reduce denied claims by ensuring accurate authorization information is documented prior to services.

🎯 Requirements

• Strong knowledge of managed care policies, insurance verification processes, and general medical office procedures. • Experience in a medical office, clinic, hospital, or dental office handling referrals, authorizations, medical records, or billing is highly preferred. • Proficiency with CPT and ICD‑9/ICD‑10 coding concepts and the ability to interpret clinical information for authorization requirements. • Familiarity with HIPAA regulations and commitment to maintaining confidentiality and privacy of patient information at all times. • Ability to navigate electronic health record (EHR) systems efficiently, with accurate and thorough documentation of all activities. • Solid understanding of medical terminology across primary care and specialty services; dental office experience is a plus. • Exceptional written and verbal communication skills to liaise effectively with providers, insurance companies, and patients. • High level of attention to detail, strong organizational skills, and the ability to manage multiple referrals and insurance requests simultaneously. • Comfortable working independently in a remote environment, meeting productivity and turnaround time expectations.

🏖️ Benefits

• Competitive hourly pay based on experience, with regular performance reviews and opportunities for pay increases. • Fully remote position with stable, full-time hours and a predictable schedule. • Comprehensive training on our systems, referral workflows, and insurance requirements, with ongoing support from experienced team members. • Opportunity to grow into senior referral, authorization, or revenue cycle roles as you develop your skills and performance. • Paid time off, paid holidays, and access to company benefits in line with organizational policies (full details provided during the hiring process). • Supportive, collaborative work environment that values accuracy, communication, and respect for every patient. • Chance to make a real impact by helping patients receive timely approvals and access the care they need while working from home.