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Healthcare Outcomes Performance Co. (HOPCo)

Referral and Authorization Coordinator

Healthcare Outcomes Performance Co. (HOPCo), Folsom, Pennsylvania, United States

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Overview Premier Orthopaedics, in partnership with Philadelphia Hand to Shoulder, is seeking a dedicated and skilled

Referral and Authorization Coordinator

to join our team in

Ridley Park/Folsom, PA . As two of the region’s most respected providers of orthopedic and upper extremity care, we offer a collaborative, patient-focused environment that prioritizes clinical excellence, innovation, and ongoing professional development.

Position Summary The Referral and Authorization Coordinator is responsible for verifying patient information, obtaining authorizations, and facilitating seamless access to care. This position supports both patients and providers by coordinating insurance requirements and ensuring accurate registration and referral processing. This is a full-time position with a standard Monday through Friday schedule.

Key Responsibilities

Verify and update patient registration information in the practice management system

Obtain benefit verification and necessary authorizations (referrals, precertifications) for ambulatory visits, procedures, injections, and radiology services

Use online verification systems and review real-time eligibility responses to ensure insurance accuracy

Create referrals and attach them to pending visits, faxing forms to providers and insurance companies as needed

Verify patient demographics, insurance eligibility, and coordination of benefits

Complete chart prepping tasks to ensure smooth patient check-in processes

Research information needed to complete registration, including coordinating with providers, ancillary staff, and patients

Review and notify front office staff of outstanding patient balances

Respond to provider and staff inquiries regarding referral status, care coordination, and follow-up

Maintain satisfactory productivity and work queue goals while ensuring timely claims reimbursement

Index referrals to existing patient accounts and create new patient accounts for non-established patients

Identify trends and communicate potential issues to the management team

Qualifications Education

High school diploma or GED required; equivalent working knowledge considered

Licenses & Certifications

None required

Experience

Minimum of 2–3 years of experience in a healthcare environment, preferably in a referral, front desk, or billing role

Must have experience with managed care insurances, requesting referrals, obtaining authorizations, and verifying insurance benefits

Knowledge of insurance plan requirements for Medicaid and commercial plans

Working knowledge of eligibility verification, prior authorizations, and government billing guidelines including Coordination of Benefits

Advanced computer skills, including proficiency with Windows-based programs

Experience with Allscripts Practice Management and EMR preferred

Compensation & Benefits

Comprehensive benefits package including medical, dental, and vision plans

100% employer-paid life insurance

401(k) retirement plan with employer match

Benefits begin the first of the month following hire date (for full-time employees)

Generous paid sick and vacation time

7 paid holidays annually

Opportunities for growth and advancement

Employee referral reward program

About Premier Orthopaedics & Philadelphia Hand To Shoulder Premier Orthopaedics and Philadelphia Hand to Shoulder Center (PHSC) are leading providers of comprehensive musculoskeletal care throughout Pennsylvania, New Jersey, and Delaware.

Premier Orthopaedics delivers expert treatment for orthopedic injuries, joint disease, interventional spine care, regenerative medicine, and comprehensive physical therapy services, supported by more than 150 providers across 50+ locations. Facilities include state-of-the-art MRI centers, outpatient surgery centers, physical therapy clinics, and orthopedic urgent care centers to ensure timely access to high-quality, patient-focused care.

Philadelphia Hand to Shoulder Center (PHSC), a division of Premier Orthopaedics, has been nationally recognized for more than 50 years for its specialized care of the hand, wrist, elbow, arm, and shoulder. Our fellowship-trained surgeons and certified Hand and Occupational Therapists collaborate to provide seamless care—from diagnosis and treatment to post-operative and rehabilitative recovery. With 14 convenient locations across Pennsylvania and New Jersey, PHSC offers advanced, integrated care to restore function, mobility, and quality of life for patients with upper extremity conditions.

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