Accountabilities:

Monitor and manage incoming patient referrals, ensuring they are reviewed and processed within established timelines.
Maintain accurate referral tracking and documentation to support patient record integrity, compliance, and safety.
Navigate client management systems and insurance company websites to locate and review diagnostic imaging orders, including CT scans, MRI scans, and PET scans.
Initiate and manage insurance authorization requests through online portals, fax, and telephone communication.
Review relevant patient clinical information and respond to insurance-related questions to obtain the necessary authorizations before scheduled procedures.
Coordinate with insurance representatives to follow up on pending authorization requests, resolve issues, and address denied cases.
Communicate professionally with physicians and healthcare providers when additional clinical information or direct intervention is required to secure authorization.
Support providers in resolving authorization denials, including coordinating requests for physicians to speak directly with insurance company clinical reviewers when necessary.
Establish and maintain effective working relationships with healthcare providers, service partners, and other relevant stakeholders.
Serve as a primary point of contact for patients and their families, helping them navigate referral processes and responding to questions or concerns.
Collect, organize, and review relevant patient clinical backgrounds and referral documentation to ensure all required information is available.
Coordinate communication between patients, families, healthcare providers, and insurance companies to facilitate timely referral processing.
Identify missing information, documentation inconsistencies, and potential delays, taking appropriate action to resolve them.
Uphold patient confidentiality, documentation standards, and applicable compliance and safety requirements.
Deliver professional, empathetic, and customer-focused service throughout the referral and authorization process.

Requirements

High school diploma or equivalent required.
Previous experience in healthcare administration, patient registration, referral coordination, medical billing, insurance authorization, or customer service is an advantage.
Familiarity with medical terminology and diagnostic imaging procedures, including CT scans, MRI scans, and PET scans, is beneficial.
Understanding of healthcare referrals, insurance authorization procedures, and patient documentation requirements is preferred.
Strong computer literacy, including prior experience using computers, keyboarding, online systems, and web-based platforms.
Ability to navigate multiple client management systems and insurance websites efficiently.
Excellent written and verbal communication skills, with clear, concise, and professional telephone etiquette.
Exceptional customer service skills and the ability to communicate effectively with patients, families, healthcare professionals, insurance representatives, and the general public.
Strong organizational skills and attention to detail, particularly when managing patient records, referral documentation, and authorization requests.
Basic mathematical skills, including addition, subtraction, multiplication, division, and percentage calculations.
Strong analytical and problem-solving abilities, with the capacity to identify issues, gather relevant information, establish facts, and reach appropriate conclusions.
Ability to prepare professional business correspondence, including emails, letters, and other written communications.
Ability to work efficiently in a fast-paced environment while managing multiple requests and competing priorities.
Self-motivated and proactive, with a strong work ethic and the ability to work independently as well as collaboratively within a team.
Professional, patient-focused attitude and the ability to handle sensitive information with discretion and care.
Flexibility and adaptability when responding to changing workloads and operational requirements.

How Jobgether works

We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.

We appreciate your interest and wish you the best!

Why Apply Through Jobgether?

Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.

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