Job description

This is a remote position.

Schedule:

40 hours per week
Monday to Friday, 9AM to 6PM Bakersfiled, CA
Includes 1 hour unpaid break

Job Summary:

We are seeking a detail-oriented and efficient Authorizations & Referrals Clerk to join our team. This role is responsible for processing 80-100 outgoing referrals and prior authorizations daily for services such as MRI, X-ray, Physical Therapy, Braces, EMG, and specialist referrals. The ideal candidate must be able to work in a fast-paced environment, demonstrate strong organizational skills, and be proficient in Electronic Medical Records (EMR) systems to ensure timely and accurate documentation.

Key Responsibilities:

Process and submit referrals and prior authorizations for diagnostic imaging, therapies, durable medical equipment (DME), and specialty consultations.
Verify insurance coverage and benefits to ensure authorization requirements are met.
Accurately document and update patient records in the Electronic Medical Records (EMR) system.
Communicate with insurance companies, providers, and patients to obtain approvals and resolve any authorization issues.
Monitor and follow up on pending authorizations to avoid delays in patient care.
Maintain organized records and ensure timely processing of all referral and authorization requests.
Work collaboratively with clinical staff, front desk, and billing departments to support smooth operations.
Stay up to date with insurance policies, referral procedures, and authorization requirements.

Qualifications & Skills:

Experience: Minimum of 1 year in a medical referrals/authorizations role, preferably in a pain management or high-volume specialty clinic.
Technical Skills: Experience with Electronic Medical Records (EMR) systems and insurance portals.
Organizational Skills: Ability to manage 80-100 referrals/authorizations daily with accuracy and efficiency.
Time Management: Ability to handle multiple tasks in a fast-paced environment while meeting deadlines.
Attention to Detail: Ensures accuracy in all documentation and submissions.
Communication Skills: Professional verbal and written communication to coordinate with providers, patients, and insurance representatives.
Problem-Solving: Ability to troubleshoot and resolve authorization issues efficiently.

Preferred Qualifications:

Experience in pain management, orthopedics, or physical therapy referrals is a plus.
Familiarity with Medicare, Medicaid, and commercial insurance authorization processes.
Bilingual (English/Spanish) preferred but not required.

Required profile