JOB SUMMARY:
The Benefits Coordinator is responsible for managing patient referrals and verifying insurance benefits to ensure timely access to care and accurate coverage information. This role serves as key liaison between patients, client, insurance companies, and external healthcare facilities, supporting a seamless coordination of services and a positive patient experience.
SHIFT AND SCHEDULE:
Full Time: Monday to Friday 8:00 am to 5:00 pm.
ESSENTIAL FUNCTIONS:
- Coordinate and process internal and external patient referrals in accordance with provider orders and payer guidelines.
- Obtain prior authorizations and referrals from insurance carriers and managed care plans as required.
- Verify patient insurance eligibility, benefits, co‑pays, deductibles, and authorization requirements prior to scheduled services.
- Communicate benefit information clearly and professionally to patients, including coverage limitations and financial responsibility.
- Liaise with insurance companies, provider offices, imaging centers, hospitals, and specialty practices to facilitate timely care.
- Track referral and authorization statuses to ensure appointments and services are completed without delay.
- Maintain accurate and complete documentation in electronic health records (EHR) and referral management systems.
- Resolve referral denials, coverage discrepancies, and authorization issues by working with payers and clinical teams.
- Maintain patient confidentiality and safeguard protected health information in compliance with HIPAA regulations.
- Support front office, clinical, and billing teams by providing accurate referral and insurance information.
- Monitor payer requirements and assist with process improvements related to referral and authorization workflows.
- Provide exceptional customer service to patients and staff in a fast‑paced healthcare environment.
KEY SUCCESS FACTORS:
- Minimum of 2 years of experience in a healthcare setting involving referrals, insurance verification, or authorizations preferred.
- Must have the ability to consistently meet performance standards of production, accuracy, completeness and quality.
- Ability to know and adhere to payer guidelines by plan and service type.
- Requires good listening and communication skills, and professional telephone etiquette.
- Ability to maintain a professional demeanor in a highly stressful and emotional environment.
- Must be able to exhibit a high level of empathy with the ability to effectively communicate with patients, while demonstrating exceptional customer service skills.
- Demonstrates ability to manage multiple, changing priorities in an effective and organized manner.
- Excellent data entry, numeric, typing and computer navigational skills.
- Basic computer skills and Microsoft Office.
BENEFITS:
- 401 K.
- Medical, Dental and Vision.
REQUIREMENTS:
- EDUCATION - H.S. Diploma/GED Equivalent.
- EXPERIENCE - 2 Years of Experience.