Disclaimer: Please note that only CVs submitted in English will be considered. Profiles not provided in English will not be taken into account.

Aviso: Tenga en cuenta que solo se considerarán las hojas de vida presentadas en inglés. Los perfiles que no se envíen en inglés no serán tenidos en cuenta.

Job Overview:

We are seeking a highly organized, detail-oriented, and proactive Prior Authorization & PCP Referral Coordinator to join our healthcare operations team. This role is responsible for managing all prior authorizations and Primary Care Physician (PCP) referrals throughout the business day to ensure patients receive timely care while minimizing treatment delays.

The adecuado candidate has experience working with U.S. healthcare insurance, prior authorization processes, and referral management. They possess strong organizational skills, excellent attention to detail, and the ability to prioritize multiple requests in a fast-paced medical environment.

Schedule: Remote, Full-Time | Monday through Friday during EST Business hours.
Responsibilities:




Prior Authorization Management
- Monitor uploaded superbills throughout the day to identify services requiring prior authorization.
- Review all designated CPT codes that require insurance authorization.
- Submit prior authorization requests through insurance portals or contact insurance companies by phone when necessary.
- Utilize the provided diagnosis codes and supporting clinical documentation to complete authorization requests.
- Process authorization requests promptly as they are received to prevent backlogs.
- Prioritize same-day authorizations for services performed on the current day whenever possible.
- Accurately document authorization numbers, approval dates, insurance reference numbers, and related information within the patient's electronic medical record (EMR).
- Follow up on pending authorizations to ensure timely approvals and minimize delays in patient care.

PCP Referral Coordination
- Verify whether

📌 Bilingual Health Insurance Specialist (Albania)
🏢 Bruntwork
📍 Albania