Cardiology Authorization/Referral Coordinator

Responsible for performing the appropriate processes to verify patient eligibility, coordinate benefits, ensure insurance coverage, and determine if prior authorization is needed for said order. If needed, obtains authorization and documents in the patient electronic medical record. Facilitates responses to patient inquiries regarding authorizations within turnaround standards.

In this role, you would be responsible for completing authorizations and referrals for our medical services. In addition to reviewing the medical history of potential patients, you will verify information provided by their referring physicians and their insurance coverage.  You will also monitor the schedule for our add-on patients, ensuring there are no conflicts and we have the prior authorization we need to move forward with their appointment or procedure. We prefer candidates who have a medical coding background but we will consider those with only experience in medical billing or insurance authorization. 

Authorization/Referral Coordinator Duties and Responsibilities:

• Complete authorizations and referrals for services, including appointments and procedures
• Review patient’s medical history and insurance coverage for approval
• Contact referring physicians for additional information as needed
• Input new patient information and update information in our system
• Monitor schedule for potential issues
• Complete billing documentation
• Assist with other clerical tasks as needed
• Initiate prior authorization for cardiac procedures and testing, and outpatient procedures
• Obtain prior authorization for procedures and testing in the office and the hospital
• Understand and explain benefits, copays, coinsurances and deductibles to patients
• Schedule patients for testing
• Document prior authorization and insurance verification notes in EMR
• Communicate with providers related to documentation for orders
• Collaborate with all IMS departments as needed

Job Skills:

• Multi task in a fast paced environment
• Detail oriented is a must
• Proficient in documentation
• Strong computer and EMR skills
• Excellent verbal and communication skills
• Team player, adaptable