What are the responsibilities and job description for the Referral & Prior Authorization Coordinator position at Generations Family Practice?
OVERALL POSITION DESCRIPTION: The Referral Coordinator manages insurance verifications, prior authorizations, and referral processes to support timely patient care. This role communicates with patients, providers, and insurance companies to ensure services are properly authorized and documented while delivering excellent customer service and maintaining compliance with company policies and HIPAA regulations.
ESSENTIAL FUNCTIONS:
- Manage inbound and outbound patient calls in a professional and timely manner.
- Verify patient insurance coverage and follow up on prior authorization status.
- Provide accurate information regarding appointments, procedures, and office policies.
- Ensure appropriate follow-up with patients, providers, and internal departments as needed.
- Deliver excellent customer service and create a positive, efficient experience for callers.
- Navigate and document within multiple internal systems simultaneously.
- Maintain compliance with company policies, procedures, and HIPAA regulations.
- Demonstrate strong problem-solving skills when addressing patient or scheduling concerns.
- Maintain proficiency with Microsoft Office and other office technology.
- Type at a minimum of 35 words per minute.
EDUCATION AND EXPERIENCE:
- High school diploma or GED required.
- Minimum of one (1) year of experience in a medical receptionist, patient services, or customer service role, or an equivalent combination of education and experience.
- Experience using Availty or similar systems required.
- Experience using Athena required.
- Certified Medical Assistant (CMA) or Registered Medical Assistant (RMA) preferred.
- Experience working with multi-line phone systems.
- Proficiency with computers, practice management software, and electronic medical records (EMR).
- Knowledge of customer service principles and best practices.
- Strong organizational skills and demonstrated initiative.
- Excellent interpersonal and communication skills with a professional and welcoming demeanor.
- Ability to work independently as well as collaboratively within a team environment.
- Ability to handle confidential information with discretion and sound judgment.
Application Question(s):
- Have you used Athena in previous roles? If so, for how many years?
- Have you used Availity or similar systems in previous roles? If so, for how many years and which systems?
Ability to Commute:
- Cary, NC 27513 (Required)
Work Location: In person