We are looking for an Insurance Referral Coordinator to support prior authorization activities for prescription therapies and related healthcare services in Blue Ash, Ohio. This Long-term Contract opportunity is ideal for someone who can work closely with primary care teams, patients, and payers to help move referrals and approvals forward efficiently. The person in this role will help ensure requests are properly documented, submitted on time, and tracked carefully so patients can access the care and medications they need.
Responsibilities:
- Gather clinical notes, patient information, and provider documentation needed to prepare complete authorization submissions.
- Send prior authorization requests to insurance carriers and proactively monitor them to help avoid delays in medication approval.
- Work with primary care providers, patients, and payer representatives to clarify missing information and address questions tied to referral and authorization activity.
- Track the progress of pending requests and communicate approvals, denials, and outstanding items to the appropriate healthcare staff.
- Maintain accurate records of authorization actions, supporting documents, and status updates within secure systems.
- Review payer rules and coverage criteria regularly to support compliant processing of prescription-related requests.
- Identify recurring denial patterns and assist with follow-up steps such as appeals, corrections, and resubmissions when needed.
- Support patient-facing coordination tasks, including appointment-related communication and record verification connected to referral workflows.
- At least 2 years of experience in prior authorizations, insurance coordination, referral processing, or a closely related healthcare support role.
- Working knowledge of medical records, patient scheduling, appointment coordination, and front-end patient support processes.
- Experience communicating with insurance providers, patients, and clinical teams in a clear and timely manner.
- Ability to organize documentation, manage multiple requests at once, and follow items through to resolution.
- Familiarity with prescription authorization workflows, especially in a primary care or outpatient setting.
- Strong attention to detail with the ability to maintain accurate and compliant documentation.
- Comfort using secure healthcare systems to enter, review, and update patient and authorization information.