Helps patients navigate through their health care needs by assisting with referrals, insurance authorizations, scheduling appointments, and answering questions.

Responsibilities:

Confirms insurance coverage via payer portals and determines necessity for pre-authorization.|

Obtains authorization and processes referrals for services ordered by providers. Schedules appointments as appropriate and within required timeframes and assuring referrals are maintained within appropriate network and/or payer requirement.|

Remains current on referral policies and procedures, payer requirements, managed care matrix, portals and determines financial responsibility for services to be provided.|

Communicates with patients, healthcare providers, and third-party service providers regarding insurance coverage and barriers to care.|

Documents detailed information in the patient medical record and any actions taken regarding authorization status, coverage issues, restrictions and appointment details. Notifies patients and providers of services requested that are not authorized by insurance.

Education: High school diploma and prior experience with insurance authorization

Pay range for position is $16.00-22.37/hr