Referral Coordinator

Prepare and submit prior authorization requests to insurance companies, including necessary medical documentation, diagnosis codes, and treatment plans.

• Clinical review :

Analyze medical records to determine if a requested service or medication aligns with medical necessity guidelines and insurance coverage.

• Communication with providers :

Contact healthcare providers to gather additional information or clarify details regarding requested services for prior authorization.

• Follow-up with insurance companies :

Monitor the status of pending prior authorization requests and follow up with insurance companies to obtain timely approvals.

• Patient education :

Explain the prior authorization process to patients, including potential delays and necessary documentation.

• Documentation :

Maintain accurate records of all prior authorization requests, including patient information, insurance details, and approval status.

• Billing support :

Collaborate with billing staff to identify and resolve potential billing issues related to prior authorizatio

• Insurance verification :

Accurately verify patient insurance information, including eligibility, benefits, and coverage details.