Medical Authorization & Referrals Specialist

Center for Family Health and Education; Long Beach (CA); On-site; USD 50,000 - 65,000; Full time

Job summary

Center for Family Health and Education seeks an Authorizations Coordinator to manage patient eligibility verification, referrals, and prior authorization processes across multiple sites.

You will communicate with primary care physicians, coordinate benefits, and maintain authorization records to ensure timely coverage and smooth patient care. Strong attention to detail and service orientation are essential.

Qualifications

• High School Diploma or GED required.
• 2 years in a medical office setting.
• 2 years of medical authorizations and referral processing.
• Knowledge of CPT codes and different types of insurances (Medi-Cal/HMO/PPO).
• Excellent telephone and communication skills.

Responsibilities

• Verify eligibility with all insurances, request authorizations/referrals.
• Contact Primary Care Physicians for required information.
• Follow up with the insurance authorization department to obtain authorizations in a timely manner.
• Create charts and upload all authorizations and referrals.
• Reports to Manager any referrals that have not met the required timeline and monitors daily reports of completed authorizations for quality assurance
• Contact patient by telephone to inform that referral has been approved or denied, and logs the event appropriately within the authorization system. When required on expedited authorizations, also verbally contacts the requesting provider of the approval or denial.
• Enters required data into authorization software accurately.
• Answers questions and educates referring providers on the processes, requirements and documentation required to authorize services that promote quality of care.
• Other duties as assigned.

Skills

Communication skills

Detail-oriented

Ability to work under pressure

Customer service

Education

High School Diploma or GED

Tools

EHR system

Medical database

Authorization software

Job description

Center for Family Health and Education seeks an Authorizations Coordinator to manage patient eligibility verification, referrals, and prior authorization processes across multiple sites.

You will communicate with primary care physicians, coordinate benefits, and maintain authorization records to ensure timely coverage and smooth patient care. Strong attention to detail and service orientation are essential.