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Role Description

Join our dynamic healthcare team at Health Services of North Texas as a Remote Referral / Authorization Coordinator, where your expertise helps streamline patient care and reduce delays in treatment. In this vital role, you will manage referral and authorization workflows from start to finish, ensuring providers, insurance companies, and patients stay informed and aligned.

• Review, enter, and process incoming referral requests and prior authorization submissions quickly and accurately according to payer requirements.
• Verify insurance coverage and benefits using online portals and phone verification to confirm eligibility, in-network providers, and authorization requirements.
• Collaborate with providers and clinic staff to obtain necessary clinical notes, orders, and supporting documentation needed for approvals.
• Utilize medical terminology, CPT codes, and ICD-9/ICD-10 coding to support accurate and complete referral and authorization requests.
• Maintain strict compliance with HIPAA and organizational privacy policies when handling patient information throughout the referral process.
• Track, monitor, and document all referral and authorization activities in the electronic health record (EHR) and other tracking tools to ensure audit readiness.
• Follow up with insurance carriers to check status, appeal denials when appropriate, and clarify any missing or incorrect information.
• Communicate clearly with providers, clinic staff, and patients about referral status, required steps, and any issues affecting scheduling or approval.
• Work closely with billing and front-office teams to reduce denied claims by ensuring accurate authorization information is documented prior to services.

Qualifications

• Strong knowledge of managed care policies, insurance verification processes, and general medical office procedures.
• Experience in a medical office, clinic, hospital, or dental office handling referrals, authorizations, medical records, or billing is highly preferred.
• Proficiency with CPT and ICD-9/ICD-10 coding concepts and the ability to interpret clinical information for authorization requirements.
• Familiarity with HIPAA regulations and commitment to maintaining confidentiality and privacy of patient information at all times.
• Ability to navigate electronic health record (EHR) systems efficiently, with accurate and thorough documentation of all activities.
• Solid understanding of medical terminology across primary care and specialty services; dental office experience is a plus.
• Exceptional written and verbal communication skills to liaise effectively with providers, insurance companies, and patients.
• High level of attention to detail, strong organizational skills, and the ability to manage multiple referrals and insurance requests simultaneously.
• Comfortable working independently in a remote environment, meeting productivity and turnaround time expectations.

Benefits

• Fully remote position supporting a mission-driven nonprofit that improves access to care across North Texas.
• Direct impact on patient experience by helping reduce delays and ensuring services are approved before appointments.
• Opportunity to deepen your knowledge of insurance, authorizations, and medical coding while working with a supportive team.
• This role is perfect for motivated professionals eager to make a difference in healthcare delivery while working remotely in a fast-paced, patient-focused environment.
• If you love problem-solving, coordination, and ensuring patients get the care they need, we encourage you to apply.