OhioHealth
Referral & Medical Authorization Coordinator
OhioHealth, Columbus, Ohio, United States, 43224
Referral & Medical Authorization Coordinator
We are more than a health system. We are a belief system.
We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to help people uncover their own power to be healthy. We inspire hope. We learn, grow, and achieve more – in our careers and in our communities.
Job Description Summary This position is responsible for processing referral requests for all providers practicing within the clinic module and ensuring that when needed, referral/authorization numbers are obtained for these services. Access to specialty and ancillary testing services is a key component for the treatment of our patients and the satisfaction of our referring providers. The responsibilities of this position are extremely important in meeting or exceeding customer satisfaction.
Responsibilities And Duties
40 %
Search electronic medical records to obtain the required clinical information needed for medical authorization and provide necessary information (records, scripts, etc.) to payer.
30 %
Review, obtain, and process all diagnostic/specialty/miscellaneous referral and authorization requests for both provider and facility.
20 %
Handle calls from internal and external sources where prioritization and time‑sensitive action is required.
10 %
Communicate with all involved parties—payer, provider, patient—as appropriate and as per protocol. Provide a standard of excellence as it relates to customer service and satisfaction for all customers.
Minimum Qualifications
High School or GED (Required)
Additional Job Description
Prior experience in obtaining healthcare pre‑authorizations
Working knowledge of ICD‑10 and CPT classification systems
Working knowledge of Anatomy & Physiology, and Medical Terminology
Experience in a physician practice or hospital setting with patient registration, front desk, and insurance knowledge required
Experience with third party payors required
Detail oriented, self‑motivated, a continuous learner with an interest in process improvement, and team player
Ability to navigate multiple computer screens and browsers quickly and accurately
Strong communication skills & professional demeanor
Able to learn and work in a remote work setting while maintaining departmental productivity and accuracy standards
Work Shift Day
Scheduled Weekly Hours 40
Department Corporate Pre Access
Seniorilty level Entry level
Employment type Full‑time
Job function Health Care Provider
Industries Hospitals and Health Care
Remote Work Disclaimer Positions marked as remote are only eligible for work from
Ohio .
Join us!
If your passion is to work in a caring environment
If you believe that learning is a life‑long process
If you strive for excellence and want to be among the best in the healthcare industry
Equal Employment Opportunity OhioHealth is an equal opportunity employer and fully supports and maintains compliance with all state, federal, and local regulations. OhioHealth does not discriminate against associates or applicants because of race, color, genetic information, religion, sex, sexual orientation, gender identity or expression, age, ancestry, national origin, veteran status, military status, pregnancy, disability, marital status, familial status, or other characteristics protected by law. Equal employment is extended to all person in all aspects of the associate‑employer relationship including recruitment, hiring, training, promotion, transfer, compensation, discipline, reduction in staff, termination, assignment of benefits, and any other term or condition of employment.
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We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to help people uncover their own power to be healthy. We inspire hope. We learn, grow, and achieve more – in our careers and in our communities.
Job Description Summary This position is responsible for processing referral requests for all providers practicing within the clinic module and ensuring that when needed, referral/authorization numbers are obtained for these services. Access to specialty and ancillary testing services is a key component for the treatment of our patients and the satisfaction of our referring providers. The responsibilities of this position are extremely important in meeting or exceeding customer satisfaction.
Responsibilities And Duties
40 %
Search electronic medical records to obtain the required clinical information needed for medical authorization and provide necessary information (records, scripts, etc.) to payer.
30 %
Review, obtain, and process all diagnostic/specialty/miscellaneous referral and authorization requests for both provider and facility.
20 %
Handle calls from internal and external sources where prioritization and time‑sensitive action is required.
10 %
Communicate with all involved parties—payer, provider, patient—as appropriate and as per protocol. Provide a standard of excellence as it relates to customer service and satisfaction for all customers.
Minimum Qualifications
High School or GED (Required)
Additional Job Description
Prior experience in obtaining healthcare pre‑authorizations
Working knowledge of ICD‑10 and CPT classification systems
Working knowledge of Anatomy & Physiology, and Medical Terminology
Experience in a physician practice or hospital setting with patient registration, front desk, and insurance knowledge required
Experience with third party payors required
Detail oriented, self‑motivated, a continuous learner with an interest in process improvement, and team player
Ability to navigate multiple computer screens and browsers quickly and accurately
Strong communication skills & professional demeanor
Able to learn and work in a remote work setting while maintaining departmental productivity and accuracy standards
Work Shift Day
Scheduled Weekly Hours 40
Department Corporate Pre Access
Seniorilty level Entry level
Employment type Full‑time
Job function Health Care Provider
Industries Hospitals and Health Care
Remote Work Disclaimer Positions marked as remote are only eligible for work from
Ohio .
Join us!
If your passion is to work in a caring environment
If you believe that learning is a life‑long process
If you strive for excellence and want to be among the best in the healthcare industry
Equal Employment Opportunity OhioHealth is an equal opportunity employer and fully supports and maintains compliance with all state, federal, and local regulations. OhioHealth does not discriminate against associates or applicants because of race, color, genetic information, religion, sex, sexual orientation, gender identity or expression, age, ancestry, national origin, veteran status, military status, pregnancy, disability, marital status, familial status, or other characteristics protected by law. Equal employment is extended to all person in all aspects of the associate‑employer relationship including recruitment, hiring, training, promotion, transfer, compensation, discipline, reduction in staff, termination, assignment of benefits, and any other term or condition of employment.
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