Oncology Referrals & Authorization Specialist

CO040 Memorial Regional Hospital; United States; On-site; USD 52,000 - 78,000; Full time

Job summary

Memorial Healthcare System is seeking a Referrals and Authorizations Coordinator in Hollywood, FL. You will secure prior authorizations and primary care referrals for inpatient and outpatient care, including surgeries and specialist visits, to ensure timely access and proper reimbursement.

Responsibilities include verifying providers, liaising with payers, and following up on pending authorizations, while applying Medicare, Medicaid, and commercial guidelines to support efficient care delivery.

Qualifications

• Knowledge of medical terminology, and insurance authorization processes.
• Familiarity with payer portals, EMR systems, and healthcare billing systems.
• Strong interpersonal and communication skills with attention to detail.

Responsibilities

• Verifies accuracy of referring provider to ensure data integrity and accuracy.
• Serves as liaison between providers, patients, and insurance companies to resolve authorization and/or referral-related issues.
• Ensures timely follow-up on pending authorizations to prevent treatment delays.
• Collaborates with clinical and scheduling teams regarding authorization status to support treatment planning and scheduling.
• Understands and applies payer-specific guidelines, including Medicare, Medicaid, and commercial insurance requirements for both practice and hospital billing.
• Obtains and documents prior authorizations and referrals for all required services.
• Processes incoming and outgoing referrals from providers, ensuring appropriate documentation and approvals are in place.
• Verifies insurance eligibility and benefits for patients, including coverage for specialty medications and services.

Skills

Accountability

Accuracy & Quality

Customer Service

Effective Communication

HIPAA

Insurance Verification

Verify Insurance

Organization Skills

Team Work

Problem Solving

Education

High School Diploma

Associate’s degree preferred

Tools

EMR systems

Payer portals

Healthcare billing systems

Job description

Memorial Healthcare System is seeking a Referrals and Authorizations Coordinator in Hollywood, FL. You will secure prior authorizations and primary care referrals for inpatient and outpatient care, including surgeries and specialist visits, to ensure timely access and proper reimbursement.

Responsibilities include verifying providers, liaising with payers, and following up on pending authorizations, while applying Medicare, Medicaid, and commercial guidelines to support efficient care delivery.