Referral CoordinatorAuthorization Specialist

SA PAIN CLINIC; San Antonio (TX); On-site; USD 42,000 - 62,000; Full time

Job summary

SA PAIN CLINIC is seeking staff to manage insurance verification, authorizations, and patient scheduling. You will update patient records with accurate insurance information and communicate essential data to the team.

The role involves reviewing authorization requirements, maintaining insurer data, and ensuring timely submissions to prevent denials. This position is based in San Antonio, Texas, and entails on-site work.

Qualifications

• Verifying insurance coverage for patients.
• Maintaining up-to-date insurance data.
• Communicating insurance information to staff.

Responsibilities

• Verify insurance coverage for potential new patients and re-verify insurance coverage for existing patients every month.
• Update patient computerized accounts with corrected insurance information.
• Determine if authorization is required for ordered services, and obtain authorization when needed.
• Maintain up-to-date information on various insurance companies and any changes.
• Communicate important insurance data to appropriate staff.
• Review procedure requests for authorization based on insurance standards and medical necessity.
• Schedule new patients.
• Submit authorizations and ensure documentation to avoid repetitious submissions and denials.

Job description

Job Description

Job Description

Referral/Authorization duties:

• Verify insurance coverage for potential new patients and re-verify insurance coverage for existing patients every month
• Update patient computerized accounts with corrected insurance information.
• Determine if authorization is required for ordered services, if authorization is required, obtain authorization from insurance
• Maintain up to date information on various insurance companies and any relevant changes.
• Communicating important insurance data to appropriate staff.
• Reviews procedure requests for authorization needed based upon insurance standards while drawing upon experience and general knowledge. Reviews documentation or contacts the provider when necessary to supplement the order to prove medical necessity.
• Schedule new patients

Ensures appropriate documentation is available and complete before submitting the authorization to the insurance company to avoid repetitious submissions and denials