Referral and Prior Authorization Coordinator

HealthHelper; United States; Remote; USD 60,000 - 80,000; Full time

Job summary

Join a mission-driven team at an innovative startup dedicated to improving healthcare efficiency. As a Referral and Prior Authorization Coordinator, you will manage workflows for specialty referrals and insurance authorizations, ensuring patients receive timely care. This fully remote role offers flexible hours and a supportive work environment focused on reducing burnout. If you thrive in a fast-paced setting and have experience in primary care, this is the perfect opportunity to make a difference in the healthcare system.

Benefits

Flexible Hours

Paid Time Off

Dental Insurance

401(k) Retirement Plan

100% Remote Work

Qualifications

• 3+ years managing referrals in primary care.
• Proficiency with multiple EHR systems.
• Strong communication and time management skills.

Responsibilities

• Manage referral work queues and validate data.
• Confirm insurance eligibility and submit requests.
• Coordinate care with providers and handle inquiries.

Skills

Referral Management

Prior Authorization

EHR Systems

Communication Skills

Attention to Detail

Education

Experience in Primary Care

Experience with Insurance Plans

Tools

Innovaccer

Arcadia

EHR Platforms

Job description

Referral and Prior Authorization Coordinator

HealthHelper is a technology-enabled services company partnering with Primary Care Practices to streamline administrative tasks such as referrals, prior authorizations, care coordination, and appointment scheduling. Our goal is to ensure patients receive timely care while practices meet their clinical and contractual objectives.

Join our fast-growing, mission-driven team to help patients navigate healthcare and enable practices to operate more efficiently. This role is suited for individuals who thrive in a fast-paced, tech-enabled environment and have extensive experience in referral coordination and insurance authorization workflows supporting primary care.

Position Title: Referral and Prior Authorization Coordinator

Location: Remote (Work from Home)

Reports to: Director of Operations

Collaborates with: Internal teams (Operations, Product) and external practice staff including providers, medical assistants, and referral coordinators.

Position Summary:

The Coordinator manages end-to-end workflows related to specialty referrals and insurance prior authorizations, working closely with primary care practices and utilizing EHR and care coordination platforms to ensure timely and accurate processing—facilitating access to appropriate care.

Responsibilities:

1. Monitor and manage referral queues across EHR and partner platforms.
2. Validate referral data, triage based on urgency, and coordinate missing information.
3. Verify insurance eligibility and determine prior authorization requirements.
4. Submit referrals and authorization requests via payer portals.
5. Collect and upload clinical documentation such as visit notes and test results.
6. Coordinate with providers to ensure successful referrals and scheduling.
7. Contact patients to confirm preferences and schedule appointments.
8. Respond to inquiries regarding referral status, scheduling, and documentation.
9. Accurately document all activities within HealthHelper systems and client EHRs.
10. Comply with HIPAA and health information privacy regulations.

Qualifications:

Required:

• Minimum 3 years managing referrals in primary care or multi-specialty settings.
• At least 2 years managing prior authorizations, including payer portal submissions and follow-up.
• Proficiency with multiple EHR systems.
• Strong attention to detail, time management, and communication skills.
• Ability to learn new software platforms quickly.

Preferred:

• Experience with New Jersey provider networks and insurance plans.
• Familiarity with population health platforms like Innovaccer or Arcadia.
• Bilingual in Spanish and English is a plus.

Why HealthHelper?

• 100% remote work with flexible hours.
• Opportunity to develop a new, growing program within an innovative startup.
• Mission-driven culture focused on patient care and reducing staff burnout.

Compensation & Benefits:

• Hourly rate: $22–$26, based on experience.
• Paid Time Off: 21 days total, including holidays and PTO.
• Dental insurance included.
• 401(k) retirement plan.
• Remote work environment.