Referral Coordinator

• Verify the need for prior authorization for scheduled procedures, diagnostic tests, and specialty services
• Submit authorization requests with complete and accurate documentation
• Monitor authorization status and follow up with payers for timely approvals
• Communicate authorization outcomes to patients, providers, and scheduling staff
• Confirm referral requirements based on insurance plans and provider contracts
• Request and obtain referrals from primary care providers or referring specialists
• Track referral approvals and maintain documentation in the EHR system
• Inform patients about authorization and referral requirements before appointments
• Provide updates on pending or denied authorizations and assist with next steps
• Educate patients on insurance processes and address concerns
• Collaborate with scheduling, clinical, and billing teams to prevent delays
• Assist medical billers in resolving claims denied for lack of authorization or referral
• Provide updates on payer requirements and process changes
• Document authorization and referral activities in the EHR system
• Maintain logs and generate authorization and referral metrics reports
• Address issues such as incorrect coding or missing documentation
• Escalate complex cases to supervisors as needed

Explore Authorization and Referral Coordinator at Panorama. Review requirements and application details.