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Insurance

• Set up process and workflow to obtain insurance prior authorizations (primary responsibility)
• Receive, track, and process incoming referrals from primary care providers and partner organizations.
• Process insurance authorizations for outbound referrals, including submitting documentation and managing denials or appeals.
• Verify insurance and referral information to ensure completeness, accuracy, and compliance.
• Communicate updates to referring providers and maintain clear, timely feedback loops to support continuity of care.
• Schedule patient appointments with OrthoPass clinicians, ensuring alignment between provider availability and patient needs.
• Manage scheduling logistics for urgent or complex cases requiring additional coordination.
• Maintain up-to-date and accurate records in the EHR and referral tracking systems.
• Partner closely with operations, clinical, and provider relations teams to ensure smooth handoffs and proactive issue resolution.
• Identify and escalate barriers to care access or workflow bottlenecks, recommending process improvements as needed.
• Support reporting and quality improvement initiatives related to referral timeliness, patient engagement, and access metrics.

Insurance Authorization Coordinator

Manager

• Develop and manage multi-channel outreach campaigns
• Create personalized education materials and automated communication strategies
• Lead patient journey mapping initiatives
• Optimize first-call resolution models
• Address and resolve patient complaints and concerns
• Support hiring, training, and management of a team of patient outreach coordinators
• Conduct regular call audits and quality reviews
• Review quality management frameworks
• Train and mentor staff on patient interaction protocols
• Work with product and clinical leadership to improve patient outreach workflows
• Monitor and report on key engagement and operational metrics

Insurance Authorization Coordinator

Manager, Patient Outreach – Engagement