This is a fully remote position, open to applicants in Nicaragua, +5 more countries.

📋 Description

• Oversee the entire referral process, which includes intake, gathering clinical documentation, processing, tracking until completion, and finalizing in Epic EMR.

• Proactively monitor and manage Epic referral and authorization workqueues on a daily basis to avoid delays in patient care.

• Communicate effectively in both English and Spanish with patients, referring provider offices, and insurance companies.

• Clarify information and resolve any authorization obstacles.

• Confirm patient coverage and benefits of their plans.

• Navigate the complexities of HMO/PPO payer guidelines.

• Obtain timely prior authorizations for specialty office visits and outpatient consultations.

• Keep precise status notes and patient records in Epic to ensure high-volume compliance and transparency.

⛳️ Requirements

• Expertise in using Epic EMR, with a preference for experience in managing Epic referral/authorization workqueues.

• Fully bilingual in English and Spanish, with both written and verbal proficiency required.

• At least 2+ years of experience in Referral Coordination and/or Prior Authorization within a U.S.-based medical practice.

• Proven track record in managing office visit authorizations and complete referral workflows.

• Comprehensive understanding of U.S. insurance carriers, including Medicare, Medicaid, and Commercial HMO/PPO plans, along with their authorization requirements.

• Excellent organizational skills and a keen attention to detail.

• Capability to independently handle a high-volume workload.

• This is a full-time contractor role, requiring 40 hours per week.

• Must be available Monday through Friday, from 8:00 a.m. to 5:00 p.m. Pacific Standard Time.