We are seeking an experienced Virtual Referral & Prior Authorization Coordinator to join a growing Primary Care and Family Medicine practice in the US.
This role requires recent, hands-on experience using eClinicalWorks (eCW) to seamlessly integrate into established workflows. You will take full ownership of processing patient referrals and insurance prior authorizations from start to finish. As you become proficient in these core responsibilities, the role will expand to include patient scheduling, phone management, and general administrative front-desk support.
Work Schedule: Monday through Friday, 8:00 AM – 5:00 PM CST.
RESPONSIBILITIES
- Referral Coordination (Primary): Prepare and submit referrals in eClinicalWorks (eCW), verify patient and insurance details, attach necessary clinical documentation, follow up with specialist offices, and track each referral to completion.
- Prior Authorizations (Primary): Verify authorization requirements, submit requests through insurance payor portals, gather supporting clinical records, track deadlines, escalate claim denials, and keep providers and patients informed.
- Administrative & Reception Support (Secondary): Handle inbound and outbound calls via Weave, schedule patient appointments, process intake and registration, update demographics, verify insurance coverage, and manage follow-up messages.
Requirements
- eClinicalWorks (eCW): Recent, hands-on experience using eCW in a US-based medical practice (mandatory).
- Referrals & Prior Auths: Proven experience managing full-cycle referrals and insurance prior authorizations independently.
- Bilingual Skills: Fully bilingual in English and Spanish with clear, professional spoken English.
- US Healthcare Experience: Direct experience working with US medical practices, ideally in Primary Care or Family Medicine.
- Adaptability: Willingness to expand responsibilities into phone management, patient scheduling, and front-desk reception duties.
- Compliance: Solid understanding of medical terminology, insurance communication, and strict HIPAA guidelines.
NICE TO HAVES
- Experience using Weave VoIP phone systems.
- High-volume referral and prior authorization handling.
- Background in insurance benefits verification and front-desk patient reception.