Referral & Coding Coordinator — ICD-10/CPT Expert

Kaiser Permanente; Atlanta (GA); On-site; USD 42,000 - 66,000; Full time

Job summary

Kaiser Permanente in Atlanta, GA seeks a Referral Coordinator to manage internal/external pre-certification referrals via phone, fax, Health Connect and online links. You will enter data using standard templates, review benefits for services requiring authorization, and ensure correct ICD-10, CPT and HCPCS coding.

You will notify members, schedule external referrals, and support the QRM/Post-Acute Regional Review Team.

Qualifications

• Minimum four (4) years of healthcare industry or relevant business experience.
• Minimum six (6) months experience receiving and processing referral requests or data entry.
• High School Diploma or GED required.
• Certified coding specialist or CPC within 6 months of hire (or equivalent)

Responsibilities

• Initiate and complete internal/external, pre-certification referral requests received.
• Enter authorization requests using the standard template and policies.
• Review member benefits and eligibility for authorization.
• Assign ICD-10, CPT and HCPCS codes for all (pre-certification) referrals.
• Notify members regarding referrals/authorization orders and scheduling external referrals.
• Support the QRM/Post-Acute Regional Review Team operations.
• Coordinate with member services and benefits departments as needed.
• Maintain current knowledge of coding guidelines to ensure compliance.

Skills

Data entry

Medical terminology

ICD-10 coding

CPT coding

Customer service

Education

High School Diploma or GED

Tools

Epic Tapestry

Authorization systems

Job description

Kaiser Permanente in Atlanta, GA seeks a Referral Coordinator to manage internal/external pre-certification referrals via phone, fax, Health Connect and online links. You will enter data using standard templates, review benefits for services requiring authorization, and ensure correct ICD-10, CPT and HCPCS coding.

You will notify members, schedule external referrals, and support the QRM/Post-Acute Regional Review Team.