Authorization and Referral Specialist (Mon-Fri) Southern ENT Specialists Holly Springs, GA Job Details Full-time $16 - $20 an hour 15 hours ago Benefits Health insurance Dental insurance 401(k) Paid time off Vision insurance 401(k) matching Qualifications Customer communication Medical insurance coverage verification Customer service Medical office experience HIPAA Medical coding experience in physician offices Medical administrative support Electronic health record (EHR) management for billing and coding Health information regulatory compliance Organizational skills Health information management Clinical confidentiality policies Clinical documentation standards Full Job Description Job Overview We are seeking a dedicated and detail-oriented Authorization and Referral Specialist to join our ENT team. In this role, you will be responsible for managing insurance prior authorizations, coordinating referrals, and ensuring compliance with clinical confidentiality policies. Your expertise will help streamline patient care coordination, facilitate accurate documentation, and support efficient communication between providers, patients, and insurance companies. This position offers an opportunity to contribute to high-quality healthcare delivery through precise authorization management and exceptional customer service. Duties Review and process insurance prior authorization requests to ensure timely approval for medical procedures and services. Verify patient insurance coverage using Electronic Health Records (EHR) systems and other relevant tools. Collaborate with healthcare providers to obtain necessary clinical documentation for authorization submissions. Manage referral coordination between primary care providers and specialists, ensuring all necessary authorizations are secured. Maintain accurate medical records and documentation in compliance with HIPAA regulations and clinical confidentiality policies. Utilize medical coding skills, including CPT (Current Procedural Terminology), ICD-9, ICD-10, and ICD coding systems, to support accurate billing and documentation processes. Communicate effectively with insurance companies, healthcare providers, and patients to resolve authorization or coverage issues promptly. Stay current with health insurance policy updates, managed care requirements, and industry best practices to ensure compliance and efficiency. Qualifications Proven experience in medical office administration or healthcare coordination roles with a focus on insurance verification and authorization processes. Strong knowledge of health insurance policies, managed care procedures, and medical billing practices. Proficiency in medical terminology, CPT coding, ICD-9/ICD-10 coding systems, and electronic health records (EHR/EHR management). Familiarity with HIPAA regulations to maintain patient confidentiality and data security at all times. Excellent organizational skills with the ability to manage multiple tasks efficiently in a fast-paced environment. Effective communication skills to liaise confidently with healthcare providers, insurance representatives, and patients. Experience using Microsoft Office applications for documentation and reporting purposes is preferred. Knowledge of clinical confidentiality policies combined with a customer service-oriented approach ensures respectful interactions with all stakeholders. Join our team as an Authorization and Referral Specialist to play a vital role in optimizing healthcare access while maintaining the highest standards of accuracy, compliance, and patient care quality!

Pay:

$16.00 - $20.00 per hour Expected hours: 40.0 per week

Benefits:

401(k) 401(k) matching Dental insurance Health insurance Paid time off Vision insurance

Work Location:

In person