The Referral Quality Coordinator serves as the primary quality checkpoint by validating referral information, documentation, and insurance details to ensure readiness for authorization. They partner with clinical teams and providers to resolve discrepancies and identify gaps to prevent delays in patient care.
The Prior Authorization Coordinator is responsible for reviewing, processing, and submitting prior authorization requests for specialty treatments while managing clinical documentation. They also serve as a liaison between patients, clinical staff, and insurance providers to resolve authorization issues and ensure timely approvals.
The Insurance Follow-Up Specialist investigates and resolves insurance claim denials while partnering with payers to secure timely reimbursement. They also provide support to patients and internal teams while managing claim submissions through various payer portals.
