Referral Authorization Specialist

Job Summary

A company is looking for a Referral / Authorization Specialist (Remote).

Key Responsibilities

• Process authorization requests and provider inquiries through various communication methods
• Verify member eligibility and benefits to facilitate authorization procedures
• Coordinate with healthcare providers to ensure accurate information exchange and maintain records of authorizations

Required Qualifications, Training, and Education

• Proficiency in medical terminology, ICD-10 coding, and prior authorization processes
• Strong computer literacy and experience with healthcare databases
• 1+ year of experience in referral and authorization coordination within the healthcare or managed care sector
• High school diploma or equivalent; Bachelor's degree in a related field is a plus
• Familiarity with State and Federal healthcare regulations