The Role
Coordinates specialty care referrals and prior authorizations through insurance portals, sends referrals to specialists, follows up with patients and providers, requests consult notes, communicates coverage requirements, responds to patient inquiries, tracks referral status, and maintains accurate patient documentation. Processes authorizations for medications, injections, and biologics while providing courteous customer service and handling incoming calls.
Summary Generated by Built In
About the Role:
The Referral Coordinator is responsible for assisting patients who require specialty care referrals. The coordinator submits all prior authorizations and referrals through the proper insurance portals for approval. Responsible for sending out the referrals to the specialists and following up with the specialists and patents to ensure they are seen.
Our Values:
Our Values:
- Put Patients First
- Empower Entrepreneurial Provider and Care Teams
- Operate with Integrity & Excellence
- Be Innovative
- Work As One Team
What You'll Do
- Handle incoming calls efficiently.
- Responsible for identifying patients’ needs, clarifying information, submitting referrals via insurance portals, faxing out referrals and following up with the patient.
- Provide courteous customer service to patients regarding referral requests.
- Request consult notes from other providers as needed.
- Responds to all patient inquiries concerning their referrals.
- Communicate with insurance companies to ensure all requests adhere to guidelines of coverage.
- Track referrals and provide follow-up as needed.
- Document all referral activities on patient files for future reference.
- Maintain accurate and organized patient file documentation.
- Process Prior Authorization for Medications, Injections, Biologics.
Skills, Knowledge & Expertise
- High school diploma or equivalent required
- At least 1 year of Call Center Experience
- Experience with Medical Terminology
- Strong verbal and written communication skills; must be able to communicate in a professional and courteous manner
- Proficient in Microsoft Office applications and insurance eligibility database
- Excellent data entry and typing skills
Preferred Qualifications
- A minimum of 1-year previous experience for both Prior Authorization and Referrals preferred
- Knowledge of E Clinical Works
- Knowledge of managed care and medical insurance plans
Environmental Job Requirements and Working Conditions
- This position is located in our Las Vegas Corporate Office - 8880 W Sunset Rd, Suite 320, Las Vegas NV 89148.
- The base pay range for this role is $19 - $23 per hour. This salary range represents our national target range for this role.
About
Astrana Health (NASDAQ: ASTH) is a physician-centric, technology-powered healthcare management company. We are building and operating a novel, integrated, value-based healthcare delivery platform to empower our physicians to provide the highest quality of end-to-end care for their patients in a cost-effective manner. Our mission is to combine our clinical experience, best-in-class delivery network, and technological expertise to improve patient outcomes, increase access to healthcare, and make the US healthcare system more efficient. Our platform currently empowers over 20,000 physicians to provide care for over 1.7 million patients nationwide. Our rapid growth and unique position at the intersection of all major healthcare stakeholders (payer, provider, and patient) gives us an unparalleled opportunity to combine clinical and technological expertise to improve patient outcomes, increase access to quality healthcare, and reduce the waste in the US healthcare system.
Skills Required
- High school diploma or equivalent
- At least 1 year of call center experience
- Experience with medical terminology
- Strong verbal and written communication skills
- Proficiency with Microsoft Office applications and insurance eligibility databases
- Excellent data entry and typing skills
- At least 1 year of prior authorization and referral experience
- Knowledge of eClinicalWorks
- Knowledge of managed care and medical insurance plans
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The Company
What We Do
Astrana Health is a physician-centric, technology-powered healthcare company that operates an integrated delivery platform. It enables providers to participate in value-based care arrangements, helping them deliver accessible, high-quality, and cost-effective care to patients. The company provides care coordination services to patients, primary care physicians, specialists, and health plans, leveraging proprietary technology to streamline operations and improve patient outcomes across local communities.
