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
Senior IC patient access coordinator
Builds
Patient appointment schedules and insurance authorization approvals
Domain
Healthcare / Vascular Surgery
Required skills
Medical terminology, Electronic Medical Records (EMR) systems, Insurance authorization protocols, Data analysis, Patient advocacy, ICD/CPT coding knowledge
Preferred skills
Appointment scheduling software, Epic Referral work queues, Peer-to-peer review processes
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; Draft letters of medical necessity for denied claims; Serve as liaison between referring offices and specialists.
Seniority
Mid-level, hands-on IC