MRI Referral and Authorization Specialist

MRI Referral & Authorization Specialist

Join to apply for the MRI Referral & Authorization Specialist role at Healthcare Outcomes Performance Co. (HOPCo).

As Center for Bone & Joint Surgery of the Palm Beaches continues to grow, we are seeking a Referral & Authorization Specialist – Full time (M-F) Onsite.

• Verifies and updates patient registration information in the practice management system.
• Obtains benefit verification and necessary authorizations (referrals, precertification) before patient arrival for all ambulatory visits, procedures, injections, and radiology services.
• Uses online, web-based verification systems and reviews real‑time eligibility responses to ensure accuracy of insurance eligibility.
• Creates appropriate referrals to attach to pending visits.
• Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms as necessary to allow processing of claims to insurance plans.
• Completes chart‑prepping tasks daily to ensure a smooth check‑in process for the patient and clinic.
• Researches all information needed to complete the registration process including obtaining information from providers, ancillary services staff, and patients.
• Fax referral form to providers that do not require any records to be sent; processes 75–80 referrals daily. For primary specialty office visits, fax referral/authorization form to PCPs and insurance companies in a timely fashion.
• Reviews and notifies front‑office staff of outstanding patient balances.
• Maintains satisfactory productivity rates and ensures the timeliness of claims reimbursement while maintaining work queue goals.
• Responds to in‑house provider and support staff questions, requests, and concerns regarding the status of patient referrals, care coordination, or follow‑up status.
• Identifies and communicates trends and/or potential issues to the management team.
• Indexes referrals to patient account for existing patients.
• Creates new patient accounts for non‑established patients to index referrals.

• High school diploma/GED or equivalent working knowledge preferred.

• Minimum one year of experience in a healthcare environment in a referral, front‑desk, or billing role.
• Minimum one year of Athena experience preferred.
• MRI authorization experience is a plus.
• Minimum one year of experience in medical insurance authorizations required.

• Competitive Health & Welfare Benefits.
• Monthly $43 stipend to use toward ancillary benefits.
• HSA with qualifying HDHP plans with company match.
• 401(k) plan with company match.
• Employee Assistance Program available 24/7.
• Paid Time Off.
• Paid Holidays.
• Closed on major holidays.
• No evenings or weekends.
• Business hours Monday‑Friday 8 a – 5 p.
• and more…