Authorization & Referral Coordinator - Healthcare

Position Overview

We are looking for a detail-oriented Authorization & Referral Coordinator to help manage critical processes that support efficient patient care and clinic operations. In this role, you will oversee referral coordination, verify insurance coverage, and obtain required authorizations for procedures and specialist visits.

Your work will ensure that patient records are complete, approvals are secured on time, and clinical teams have the information they need to deliver care without delays. This position plays an important role in maintaining smooth communication between providers, insurance partners, and internal departments.

Key Responsibilities

• Review upcoming schedules to identify patients requiring referrals or insurance authorizations prior to their appointments or procedures.
• Verify patient insurance eligibility and coordinate with providers and insurance representatives to address coverage discrepancies.
• Prepare, submit, and track referral requests and pre-surgical authorization applications in accordance with payer guidelines.
• Maintain accurate and well-organized patient documentation within the Electronic Health Record (EHR/EMR) system.
• Monitor patient benefits, co-pay requirements, and coverage limitations related to specialist consultations and medical procedures.
• Communicate with clinics, scheduling teams, and call center staff regarding authorization status, pending approvals, or delays in processing.
• Remain current with insurance policies, referral workflows, and coding requirements to ensure compliance and efficient processing.

Skills and Competencies

• Strong organizational and time-management abilities with exceptional attention to detail.
• Professional communication skills with a patient-focused and service-oriented approach.
• Ability to manage multiple priorities and maintain accuracy in a high-volume, fast-paced environment.
• Working knowledge of medical billing practices, insurance verification, and authorization processes.
• Familiarity with CPT and ICD-10 coding, including the use of modifiers.
• Proficiency with digital productivity tools such as Google Workspace and the ability to quickly adapt to new systems or platforms.
• Flexibility to work night shifts and report on-site when operational needs require.

Job Type: Full-time

Pay: Php30,000.00 - Php35,000.00 per month

Benefits:

• Health insurance

Work Location: In person