Authorization Coordinator- Remote
Location: 100% Remote
Schedule: Monday-Friday, 9:00 AM - 5:00 PM
Overview
We are seeking a detail-oriented Referral Coordinator to support a healthcare organization by processing referral requests accurately and efficiently. This role is critical in ensuring timely determinations while coordinating with providers, clinical staff, and internal teams in accordance with Utilization Management (UM) guidelines.
Responsibilities
- Review and process referral requests in alignment with established Utilization Management protocols and standards
- Route referrals to physicians, nurses, or appropriate clinical staff when additional review is required
- Ensure all referrals are completed within required turnaround timeframes while maintaining a high level of accuracy
- Monitor and manage daily referral queues, prioritizing workload to meet service and quality standards
- Provide timely updates and assist providers and patients with referral status inquiries
- Gather and document necessary medical information to support referral determinations
- Accurately document referral activity, updates, and determinations in accordance with standard procedures
- Ensure compliance with health plan requirements, policies, and contractual obligations
- Identify potential issues or delays and proactively communicate concerns to leadership and stakeholders
- Support continuous improvement initiatives by contributing to workflow and process enhancements
Qualifications
- High school diploma or equivalent required
- Knowledge of medical terminology and healthcare processes
- Familiarity with coding systems such as CPT, HCPCS, and ICD
- Experience working with referrals, claims, or utilization management processes preferred
- Proficiency in Microsoft Office (Excel, Word) and healthcare systems
- Strong attention to detail with a high level of accuracy
- Excellent communication skills with the ability to convey information clearly and concisely
- Strong problem-solving and critical-thinking abilities related to referrals and claims processes
- Ability to manage multiple priorities in a fast-paced environment
- Highly organized with the ability to track and complete tasks within strict deadlines
- Adaptability to changing priorities, systems, and workflow demands
Benefit offerings include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and 401K plan. Our program provides employees the flexibility to choose the type of coverage that meets their individual needs. Available paid leave may include Paid Sick Leave, where required by law; any other paid leave required by Federal, State, or local law; and Holiday pay upon meeting eligibility criteria. Pay Details: $24.00 to $23.00 per hour
Search managed by: Savannah Mckillip
Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.
Equal Opportunity Employer/Veterans/Disabled
Military connected talent encouraged to apply
To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.lhh.com/us/en/candidate-privacy
The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:
- The California Fair Chance Act
- Los Angeles City Fair Chance Ordinance
- Los Angeles County Fair Chance Ordinance for Employers
- San Francisco Fair Chance Ordinance
Massachusetts Candidates Only: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
Authorization Coordinator- Remote
Location: 100% Remote
Schedule: Monday-Friday, 9:00 AM - 5:00 PM
Overview
We are seeking a detail-oriented Referral Coordinator to support a healthcare organization by processing referral requests accurately and efficiently. This role is critical in ensuring timely determinations while coordinating with providers, clinical staff, and internal teams in accordance with Utilization Management (UM) guidelines.
Responsibilities
- Review and process referral requests in alignment with established Utilization Management protocols and standards
- Route referrals to physicians, nurses, or appropriate clinical staff when additional review is required
- Ensure all referrals are completed within required turnaround timeframes while maintaining a high level of accuracy
- Monitor and manage daily referral queues, prioritizing workload to meet service and quality standards
- Provide timely updates and assist providers and patients with referral status inquiries
- Gather and document necessary medical information to support referral determinations
- Accurately document referral activity, updates, and determinations in accordance with standard procedures
- Ensure compliance with health plan requirements, policies, and contractual obligations
- Identify potential issues or delays and proactively communicate concerns to leadership and stakeholders
- Support continuous improvement initiatives by contributing to workflow and process enhancements
Qualifications
- High school diploma or equivalent required
- Knowledge of medical terminology and healthcare processes
- Familiarity with coding systems such as CPT, HCPCS, and ICD
- Experience working with referrals, claims, or utilization management processes preferred
- Proficiency in Microsoft Office (Excel, Word) and healthcare systems
- Strong attention to detail with a high level of accuracy
- Excellent communication skills with the ability to convey information clearly and concisely
- Strong problem-solving and critical-thinking abilities related to referrals and claims processes
- Ability to manage multiple priorities in a fast-paced environment
- Highly organized with the ability to track and complete tasks within strict deadlines
- Adaptability to changing priorities, systems, and workflow demands
Benefit offerings include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and 401K plan. Our program provides employees the flexibility to choose the type of coverage that meets their individual needs. Available paid leave may include Paid Sick Leave, where required by law; any other paid leave required by Federal, State, or local law; and Holiday pay upon meeting eligibility criteria. Pay Details: $24.00 to $23.00 per hour
Search managed by: Savannah Mckillip
Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.
Equal Opportunity Employer/Veterans/Disabled
Military connected talent encouraged to apply
To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.lhh.com/us/en/candidate-privacy
The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:
- The California Fair Chance Act
- Los Angeles City Fair Chance Ordinance
- Los Angeles County Fair Chance Ordinance for Employers
- San Francisco Fair Chance Ordinance
Massachusetts Candidates Only: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
