Preauthorization and Referral Assistant

Beloit Health System is looking to add a Preauthorization & Referral Assistant to ou r Insurance & Billing t eam !

• Shift: First
• Schedule: 8a – 4:30 p
• Hours per week: 40

We are seeking a detail-oriented and patient-focused Preauthorization and Referral Assistant to join our healthcare team.

This role is responsible for obtaining insurance preauthorizations, processing referrals, verifying patient benefits, and coordinating with providers, insurance companies, and patients to ensure timely access to care.

The ideal candidate will have strong organizational skills, experience in medical office operations, and a commitment to delivering excellent patient service.

• Obtain and track insurance preauthorizations for procedures, diagnostic studies, medications, and specialty services.
• Process incoming and outgoing referrals accurately and in a timely manner.
• Verify patient insurance coverage, eligibility, benefits, and authorization requirements.
• Communicate with insurance companies regarding authorization status, denials, appeals, and additional documentation requests.
• Coordinate with providers and clinical staff to gather necessary medical records and supporting documentation.
• Notify patients of authorization and referral status, appointment requirements, and any insurance-related issues.
• Maintain accurate records in the electronic health record (EHR) system and referral tracking systems.
• Monitor authorization expiration dates and obtain renewals as needed.
• Ensure compliance with HIPAA and all applicable healthcare regulations.
• Assist with resolving billing and insurance-related issues connected to referrals and authorizations.
• Support front office and administrative functions as assigned.