Referral & Insurance Authorization Specialist

Socket.dev; Gastonia (NC); On-site; USD 21,000 - 30,000; Full time

Job summary

Socket.dev is seeking a Referral Coordinator for our Customer Care Office to manage insurance verification and authorization for patient referrals. This role reports to the Customer Care Supervisor and requires careful adherence to HIPAA and medical terminology.

The position involves coordinating with in-network and out-of-network carriers, entering documentation in Allscripts, and ensuring timely referrals for EMG, CT, MRI, and other procedures.

Qualifications

• High School Diploma or GED; two years related experience and/or training; equivalent combination of education and experience.
• Basic MS Excel and MS Word skills.
• Knowledge of ICD-9 and CPT codes for authorizations.

Responsibilities

• Obtain insurance authorization from in-network and out-of-network carriers for referred patients and follow-up visits with specialty care providers.
• Process physician referral orders (EMG, CT, MRI, etc.) using Allscripts EMR; obtain required insurance authorization.
• Coordinate new therapy referrals requiring authorization (AHCCCS, work comp); obtain necessary approvals.
• Enter notes into Allscripts regarding insurance authorization communications and scan documents into patient charts.
• Maintain confidentiality of records and communicate with all levels of personnel.

Skills

High-volume patient flow

Insurance knowledge

MS Excel

MS Word

Education

High School Diploma or GED

Tools

MS Excel

MS Word

Job description

Socket.dev is seeking a Referral Coordinator for our Customer Care Office to manage insurance verification and authorization for patient referrals. This role reports to the Customer Care Supervisor and requires careful adherence to HIPAA and medical terminology.

The position involves coordinating with in-network and out-of-network carriers, entering documentation in Allscripts, and ensuring timely referrals for EMG, CT, MRI, and other procedures.