Referral/Pre Auth Coordinator

NKC Health; Kansas City (MO); On-site; USD 40,000 - 55,000; Full time

Benefits offered by this job

Comprehensive Benefits (Medical, Dental, Vision, Life, FSA)

Employer matched retirement plan

Paid time off for personal/vacation/sick

Six paid holidays per year

Educational assistance

Day shift schedules

Job summary

NKC Health in Kansas City is seeking a Referral/Pre-Authorization Coordinator to facilitate referrals and pre-authorizations for patient care. The role requires collaboration with the healthcare team and patients to ensure a smooth referral process.

Ideal candidates will have a high school diploma and two years of experience in a physician's office, as well as knowledge of medical terminology. Competitive benefits and a supportive work environment are offered.

Qualifications

• Minimum two years of experience in a physician office preferred.
• Knowledge of various insurance company requirements for pre‑certification and referrals.

Responsibilities

• Coordinate referrals and pre-authorizations.
• Act as a liaison between healthcare team, patients, and specialists.
• Utilize EMR system effectively for capturing patient information.
• Provide education to patients about the referral process.

Skills

Working knowledge of medical terminology

Basic office skills

Critical thinking

Detail oriented

Ability to multitask

Education

High school graduate or GED

Job description

Here at NKC Health our mission is to empower hope and healing in every life we touch. Whether you are serving patients at a primary care clinic, specialty clinic, or in a support capacity, every team member works together to complete this mission.

NKC Health Primary Care - Gashland clinic hiring a Referral/Pre-Authorization Coordinator!

Why NKC Health Medical Group?

• Comprehensive Benefits (Medical, Dental, Vision, Life, FSA)
• Employer matched retirement plan
• Competitive wages
• Paid time off for personal/vacation/sick
• Six paid holidays per year
• Educational assistance
• Day shift schedules

What are the typical hours on the job?

The hours of operation for the Gashland clinic are Monday‑Friday, 7:30am‑5pm. Your primary schedule will be during those hours, with periodic need to work outside your schedule to serve our patients.

What does a Referral/Pre-Authorization Coordinator do?

Under the direction of the Practice Manager or Supervisor, Patient Services, this position is responsible for coordinating and ensuring referrals and/or pre-authorizations are managed and addressed appropriately. Works collaboratively with the health care team and the patient to schedule referral appointments, and independently completes the process for required pre‑certification and prior authorizations in a timely manner.

What does a typical day on the job look like?

• Provides quality service by acting as a liaison between healthcare team, patient and specialists to coordinate outpatient referrals and obtain pre‑certifications or prior authorizations as necessary.
• Utilizes the EMR system to its full potential in capturing the necessary information needed for making an appointment and communicating necessary information such as referral requirements, patient demographic information, insurance and approval information, and comments about specific patient information key to a successful appointment.
• Provides education to patients about the importance of the referral process and service provided by the physician’s office, which may include subspecialty focus.
• Coordinates efforts between providers, gathering and providing information key to appointment success.
• Communicates to physicians and other health care providers the various requirements and processes involved with medical referral authorizations for the most expedient patient appointment and successful visit.
• Completes the referral and/or preauthorization process by ensuring the specialists’ report or test results are received.
• Notifies the referring physician when a patient does not keep a referral appointment or a pre‑authorization is denied.
• Monitors incoming patient paperwork to be scanned and flags results that are to be reviewed by the physician.
• Completes FMLA, ADA and other medical paperwork as directed by the physician.

What are the requirements for the job?

• High school graduate or GED
• Minimum two years of experience in a physician office preferred.
• Working knowledge of medical terminology and knowledge of various insurance company requirements for pre‑certification and referrals.
• Basic office skills, critical thinking, detail oriented and able to multitask in a fast paced environment.

Our North Star

Here at NKC Health, we believe in care empowered. Our actions are the concrete things we do to differentiate ourselves: we lead with heart, we always move forward, and we connect to more.

NKC Health is an Equal Opportunity Employer and values diversity in our organization. We do not discriminate against any applicant for employment or employee on the basis of race, color, religion, gender, age, marital status, sexual orientation, national origin, disability, veteran status or any other classification protected by applicable discrimination laws.