Patient Referral & Authorization Specialist

El Rio; Show Low (AZ); On-site; USD 38,000 - 52,000; Full time

Job summary

Elk Ridge Community Health is seeking a Referral Coordinator for Show Low to coordinate patient referrals, obtain prior authorizations, and maintain EMR documentation. You will ensure timely referrals and accurate payer data, while upholding HIPAA and compliance standards.

The role requires clerical medical office experience, appointment scheduling, and familiarity with AHCCCS/Managed Care plans; a fingerprint clearance card is preferred. Bilingual abilities are a plus.

Qualifications

• Education: High School Degree or GED.
• 1 year of clerical experience in a medical office with knowledge of medical procedures.
• Experience in appointment scheduling and extensive public contact work.
• Experience with AHCCCS and Managed Care plans.
• Level I fingerprint clearance card: current valid and in good standing or have applied for it within seven working days after beginning employment.

Responsibilities

• Provides quality customer service to patients who require a referral to a specialist.
• Arranges appointments; notifies patient and/or family of appointment date and any special instructions regarding the specialist’s appointment.
• Documents all patient services in the EMR and NextGen identifying data, payer codes, CPT, and ICD Codes.
• Maintains standards for productivity, timeliness, and accuracy of all referrals.
• Complies with approved quality control policies and procedures.
• Maintains patient confidentiality by HIPAA and corporate compliance requirements.

Skills

Clerical experience

Medical office

Appointment scheduling

Public contact

Education

High School / GED

Tools

AHCCCS

Managed Care plans

Job description

Elk Ridge Community Health is seeking a Referral Coordinator for Show Low to coordinate patient referrals, obtain prior authorizations, and maintain EMR documentation. You will ensure timely referrals and accurate payer data, while upholding HIPAA and compliance standards.

The role requires clerical medical office experience, appointment scheduling, and familiarity with AHCCCS/Managed Care plans; a fingerprint clearance card is preferred. Bilingual abilities are a plus.