Insurance Authorization Coordinator

Job Description

REQUIREMENTS

• Experience: 2–3 years processing insurance prior authorization referrals (REQUIRED)
• Communication: Excellent written and verbal communication skills; comfortable engaging patients and providers by phone and electronically.
• Organization: Strong time management and attention to detail; able to manage multiple patient cases simultaneously.
• Systems: Familiarity with EHR systems, referral management tools, and HIPAA compliance.
• Problem-Solving: Resourceful, proactive, and comfortable resolving scheduling or documentation barriers quickly.
• Empathy: Patient-centered approach with a calm and compassionate demeanor.
• Healthcare Knowledge (Preferred): Background in musculoskeletal, primary care, or specialty care coordination.

RESPONSIBILITIES

Referral and Authorization Management

• Set up process and workflow to obtain insurance prior authorizations (primary responsibility)
• Receive, track, and process incoming referrals from primary care providers and partner organizations.
• Process insurance authorizations for outbound referrals, including submitting documentation and managing denials or appeals.
• Verify insurance and referral information to ensure completeness, accuracy, and compliance.
• Communicate updates to referring providers and maintain clear, timely feedback loops to support continuity of care.

Scheduling & Workflow Support

• Schedule patient appointments with OrthoPass clinicians, ensuring alignment between provider availability and patient needs.
• Manage scheduling logistics for urgent or complex cases requiring additional coordination.
• Maintain up-to-date and accurate records in the EHR and referral tracking systems.

Collaboration & Communication

• Partner closely with operations, clinical, and provider relations teams to ensure smooth handoffs and proactive issue resolution.
• Identify and escalate barriers to care access or workflow bottlenecks, recommending process improvements as needed.
• Support reporting and quality improvement initiatives related to referral timeliness, patient engagement, and access metrics.

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