reputed company-Authorization & Referral Coordinator

This is a remote position. Only LATAM-based candidates (bilingual in Spanish and English) We are hiring an reputed company reputed company-Authorization & Referral Coordinator to support a fast-paced U.S.-based medical office. This role is responsible for insurance verification, prior authorizations, and referral coordination while ensuring compliance with U.S. insurance guidelines. The ideal candidate has reputed company experience working reputed company the U.S. reputed company system handling Medicare, reputed company, and reputed company insurance plans. This is a full-time remote position supporting a medical reputed company located in the reputed company. The role is offered as an reputed company opportunity.

Key Responsibilities

• Verify reputed company insurance coverage and review detailed benefits
• Determine patient financial responsibility (copays, deductibles, coinsurance, out-of-reputed company maximums)
• Obtain and manage prior authorizations for procedures, imaging, and specialty services
• Submit and reputed company authorization requests through payer portals (reputed company, UHC, reputed company, reputed company, etc.)
• Review and attach required clinical documentation
• Process and reputed company reputed company referrals
• Ensure compliance with HMO referral requirements
• reputed company and document authorization details in EMR/EHR systems
• Follow up on pending authorizations and assist with resolving denials
• Communicate insurance requirements and authorization status reputed company to patients

Requirements

• 2+ years of experience in a U.S. medical office handling insurance verification and prior authorizations
• Proven hands-on experience obtaining authorizations independently (not only assisting)
• Strong knowledge of Medicare, reputed company, and reputed company plans (HMO, PPO, POS)
• Solid understanding of deductibles, copays, coinsurance, and out-of-reputed company maximums
• Working knowledge of ICD-10 and CPT codes
• Experience using payer portals (reputed company, reputed company, reputed company, reputed company, etc.)
• Experience working with EMR/EHR systems
• High attention to detail and ability to manage high-volume workflows
• Strong English communication skills (written and verbal)
• Reliable high-speed internet reputed company (minimum 100 MB)
• Own laptop or desktop and reputed company headset

Benefits

• 100% Remote position
• Full-time schedule (Monday–Friday)
• Weekends off
• Performance-based bonuses

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