Referral and Prior Authorization Rep III
Core
Patient referral and prior authorization specialist managing department referrals, insurance authorizations, and appointment coordination for Vascular Surgery.
Role type
Patient access and prior authorization coordinator
Builds
Patient appointment schedules and insurance approvals for specialty services
Domain
Healthcare administration / Vascular Surgery
Required skills
Medical terminology, Electronic medical records (Epic), Insurance authorization protocols, Data analysis, Patient advocacy, Compliance adherence
Preferred skills
Appointment scheduling software, Complex medical coding (ICD/CPT), Peer-to-peer review coordination
Responsibilities
Manage department referrals and coordinate patient appointments; Obtain and track insurance prior authorizations for tests and procedures; Communicate with patients, families, and clinical staff to resolve barriers; Analyze data to track patient compliance and improve scheduling efficiency; Escalate cases requiring medical assessment; Draft letters of medical necessity for denied claims.
Seniority
Mid-level individual contributor