Prior Authorizations & Referral Coordinator – Part-Time

St. Charles Health System; United States; Remote; USD 30,114 - 40,666; Part time

Job summary

St. Charles Health System is seeking a Prior Authorizations and Referral Management Representative to coordinate prior authorizations and referrals for patients across services, testing, and surgery.

You will liaise between patients and care teams, ensuring accurate benefit verification and efficient scheduling. The role requires a high school diploma or GED, at least one year of related experience, and basic medical coding knowledge.

Qualifications

• Required: High School diploma or GED.
• Minimum of one year experience working in hospital, clinic, or medical insurance billing office, performing duties related to medical billing, pre-authorization, claims processing, or a related area of expertise.
• Basic understanding of medical coding.

Responsibilities

• Coordinate prior authorization and referral processes for services, testing, specialty care, diagnostic procedures, and surgery.
• Facilitate scheduling coordination with surgery department, specialists and ancillary departments.
• Communicate provider, facility, and order information to health plans as part of the authorization and referral process.
• Notify health plan and obtain financial clearance for planned care requiring prior authorization.
• Assist with patient education and follow up regarding authorizations and referrals.
• Maintain and update systems with current information and track orders to ensure timely processing.

Skills

Communication

Organizational skills

Multitasking

Customer service

Attention to detail

Teamwork

Education

High School diploma or GED

College level course work

Tools

MS Office

MS Teams

Excel

EMR system

Job description

St. Charles Health System is seeking a Prior Authorizations and Referral Management Representative to coordinate prior authorizations and referrals for patients across services, testing, and surgery.

You will liaise between patients and care teams, ensuring accurate benefit verification and efficient scheduling. The role requires a high school diploma or GED, at least one year of related experience, and basic medical coding knowledge.