Authorization & Referral Coordinator

Time Type: Full time

Hours per Pay Period: 80

Shift: Day Shift 8-80

Minimum: $27.21 USD

Maximum: $34.98 USD (This represents the rate for an individual with significant experience in this job)

Department: Patient Access - Admissions

Authorization and Referral Coordinator The Authorization and Referral Coordinator is responsible for coordinating, monitoring, and facilitating authorization, referral, pre-certification, notification, and related payer requirements necessary for scheduled and unscheduled patient services. Serves as a central resource and liaison between physician offices, providers, clinical departments, Case Management, Utilization Review, Patient Access, insurance companies, and other hospital partners to promote timely and accurate financial clearance and minimize barriers to patient care.

Under general supervision, the coordinator evaluates authorization and referral requirements, establishes appropriate workflow and follow-up priorities, coordinates the exchange of required information, monitors outstanding requests, and facilitates resolution of issues that may delay or prevent authorization or referral completion. The position ensures authorization and referral information is accurate, appropriately documented, communicated to affected stakeholders, and aligned with payer, regulatory, departmental, and organizational requirements.

The Authorization and Referral Coordinator Serves as a central resource and liaison for internal and external customers, including physician offices, providers, clinical departments, Case Management, Utilization Review, Patient Access, insurance companies, and other hospital partners, to promote timely and accurate financial clearance and minimize barriers to patient care.

Supports the organization’s mission, vision, and values by adhering to the behavioral standards of Bay Area Hospital. Comply with all applicable laws, regulations, and organizational policies affecting Bay Area Hospital. Maintains familiarity with and adherence to the Code of Conduct and supports the Bay Area Hospital Compliance Program. Demonstrates effective communication skills and the ability to work collaboratively and professionally with individuals from diverse backgrounds.

The Authorization and Referral Coordinator is responsible for coordinating, monitoring, and facilitating authorization, referral, pre-certification, notification, and related payer requirements necessary for scheduled and unscheduled patient services. Serves as a central resource and liaison between physician offices, providers, clinical departments, Case Management, Utilization Review, Patient Access, insurance companies, and other hospital partners to promote timely and accurate financial clearance and minimize barriers to patient care.

Under general supervision, the coordinator evaluates authorization and referral requirements, establishes appropriate workflow and follow-up priorities, coordinates the exchange of required information, monitors outstanding requests, and facilitates resolution of issues that may delay or prevent authorization or referral completion. The position ensures authorization and referral information is accurate, appropriately documented, communicated to affected stakeholders, and aligned with payer, regulatory, departmental, and organizational requirements.

The Authorization and Referral Coordinator Serves as a central resource and liaison for internal and external customers, including physician offices, providers, clinical departments, Case Management, Utilization Review, Patient Access, insurance companies, and other hospital partners, to promote timely and accurate financial clearance and minimize barriers to patient care.

• Coordinates the overall authorization and referral workflow for assigned services, including scheduled and unscheduled services, ensuring requirements are identified, addressed, documented, and communicated within established timelines.
• Serves as a primary coordination point between hospital departments, physician offices, providers, payers, and other stakeholders regarding authorization, referral, pre-certification, notification, and related payer requirements.
• Reviews scheduled services and patient accounts to identify authorization, referral, pre-certification, notification, medical necessity, and other payer requirements and determines appropriate next…