Care Coordinator Authorization Scheduling Specialist

Advocate Health; Macon (GA); On-site; USD 38,000 - 54,000; Full time

Job summary

Advocate Health is seeking a Referral Coordinator to manage patient referrals, coordinate with multiple departments, and obtain necessary authorizations. You will work with patients to explain insurance coverage and assist with scheduling procedures and tests.

Responsibilities include coordinating schedules, reviewing benefits, and ensuring no care gaps through timely follow-up, while guiding patients to appropriate providers within their plan.

Qualifications

• Requires customer service experience.
• Familiar with insurance coverage policies.
• Proficient with computers and basic software.
• Experience reviewing insurance benefits is a plus.

Responsibilities

• Completes referrals for patients and coordinates with referring and receiving practices and/or departments.
• May coordinate and prepare financial estimates for patients.
• Obtains all authorizations needed.
• Directs patients to providers in their insurance plan.
• Reviews benefits and educates patient on insurance coverage.
• Coordinates and schedules surgical procedures, diagnostic testing, or other services within various departments with internal and ancillary providers.
• Reviews schedules and confirms schedules are accurate and time is properly allocated.
• Follows up on all referrals to ensure no care gaps.

Skills

Customer service

Insurance coverage knowledge

Scheduling coordination

Communication skills

Education

High School Diploma or GED

Tools

Medical records software

Office software (MS Office)

Job description

Essential Functions

• Completes referrals for patients and coordinates with referring and receiving practices and/or departments.
• May coordinate and prepare financial estimates for patients.
• Obtains all authorizations needed.
• Directs patients to providers in their insurance plan.
• Reviews benefits and educates patient on insurance coverage.
• Coordinates and schedules surgical procedures, diagnostic testing, or other services within various departments with internal and ancillary providers.
• Reviews schedules and confirms schedules are accurate and time is properly allocated.
• Follows up on all referrals to ensure no care gaps.

Physical Requirements

Must be able to sit for long periods of time and work in a fast-paced office environment. Should be able to bend and lift up to 10 lbs.

Education, Experience and Certifications

High School Diploma or GED required. Computer experience required. Thorough understanding of Insurance coverage (FSC/Coverage/Plan types) and Medical Necessity policies preferred. Knowledge of medical records software preferred. Customer service experience required.