Job Description:
• Accurately enter incoming patient referrals into internal systems and electronic health records in accordance with established workflows and timelines
• Review referral documentation for completeness and follow up with providers or internal teams to obtain missing information
• Ensure referrals meet eligibility and intake criteria, flagging any discrepancies or issues for resolution
• Maintain organized and up-to-date records of referral activity
• Serve as a primary point of contact for patients and families, providing timely and empathetic communication via phone, email, text, or secure messaging
• Assist with scheduling, onboarding, and general inquiries related to care services
• Guide families through next steps in the care journey, ensuring clarity and a positive experience
• Confirm patient insurance eligibility and benefits using EHR, clearinghouses, and payer portals as needed
• Communicate benefit information to patients in a clear and supportive manner
• Identify potential coverage issues and escalate as needed
• Identify when prior authorization is required based on payer guidelines and services
• Prepare and submit prior authorization requests using payer-specific workflows (portals, fax, etc.)
• Track authorization status, follow up on pending requests, and support resolution of denials
• Maintain accurate documentation of all authorization activity
• Support patient billing and collections processes, including communicating financial responsibility and collecting payments when appropriate
• Assist with resolving patient billing inquiries in a timely and professional manner
• Ensure a transparent, compassionate approach to financial interactions with families
• Collaborate with the revenue cycle team to improve collection workflows and reduce outstanding balances
• Develop, document, and maintain standard operating procedures (SOPs) and job aides for core workflows
• Continuously update documentation to reflect process improvements and system changes
• Identify opportunities to standardize and streamline workflows across the practice
Requirements:
• 2+ years of experience in a medical front office, referral coordination, billing, or healthcare operations role (required)
• Familiarity with insurance verification, prior authorizations, and patient-facing administrative workflows
• Bilingual (English/Spanish)
• Experience working with therapy or pediatric outpatient services (PT/OT/SLP) or similar specialties (preferred)
• Strong organizational skills and attention to detail
• Excellent written, verbal, and customer communication skills, with a patient-first mindset
• Comfortable working independently in a remote, fast-paced environment
• Proficiency with EHR/EMR systems and payer portals
• Passionate about improving access to care for children and families
Benefits:
• Competitive salary based on experience
• Equity package
• Flexible, remote-first work environment
• Opportunity to grow within a high-growth company
• Mission-driven team focused on improving pediatric developmental care
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