Referral & Authorization Care Coordinator
New
O
Oshi HealthDigital Health
Locations Hiring From: Arizona, Delaware, Florida, Georgia, Idaho, Indiana, Louisiana, Missouri, New Hampshire, North Carolina, South Carolina, Tennessee, Texas, Vermont, Virginia ONLY., Monday- Friday 12-8pm ESTFull-TimeMiddle
Salary47,000 - 52,000 USD per year
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Job Details
- Experience
- 2-3 years
- Required Skills
- EHR
Requirements
- Minimum of 2-3 years experience in healthcare coordination, care, or case management within a remote digital healthcare space.
- Completed degree in a health and science related field (e.g., biology, psychology, health science, nutrition, nursing).
- Fluent in healthcare terminology with a working understanding of clinical concepts.
- Background knowledge navigating health insurance plans and coverage.
- Ability to provide benefits breakdown analysis to consumers.
- Competency with common administrative technologies such as Zoom, Slack, and Microsoft Office.
- Experience charting electronically in EMR/EHR systems.
- Must reside in one of the approved states: AZ, DE, FL, GA, ID, IN, LA, MO, NH, NC, SC, TN, TX, VT, VA.
Responsibilities
- Collaborate with a multidisciplinary team of care providers to provide a whole-person approach to member care.
- Coordinate, track, and communicate patient referrals, prior authorizations, and medical records.
- Provide complete and accurate registration of referrals and authorizations, including patient demographics, insurance information, and clinical documentation.
- Apply knowledge of CPT and ICD-10 codes to obtain authorizations in compliance with payer medical policy guidelines.
- Initiate appeals for denied authorizations and maintain close follow-up.
- Engage in external coordination of pharmacy support services.
- Assist members in accessing services and provide personalized customer service.
- Manage key reports and track data to identify successes and operational refinements.
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