Referral & Authorization Care Coordinator

Responsibilities

• Collaborate with a multidisciplinary team of care providers to provide a whole-person approach to member care
• Coordinate, track, and communicate patient referrals, prior authorizations, and medical records
• Provide accurate registration of referrals and authorizations including demographics and insurance information
• Apply knowledge of CPT and ICD-10 codes to obtain authorizations in a timely manner
• Initiate appeals for denied authorizations and maintain close follow-up
• Engage in external coordination of pharmacy support services
• Assist members in accessing services and provide personalized customer service
• Manage key reports and track relevant data to drive operational refinements

Requirements

• Bachelor's Degree in Healthcare administration or equivalent coursework
• Minimum of 2-3 years experience in healthcare coordination, care, or case management within a remote digital healthcare space
• Completed degree in a health and science related field (biology, psychology, health science, nutrition, nursing, etc.)
• Fluency in healthcare terminology and understanding of clinical concepts
• Background knowledge navigating health insurance plans and coverage
• Competence with administrative technologies including Zoom, Slack, Office, and EMR/EHR systems

Preferred Qualifications

• Experience working in telehealth or a digital health environment
• Strong critical thinking skills with ability to triage and escalate appropriately
• Experience in a high-growth startup or mission-driven healthcare organization

Benefits

• Salary range of $47,000 – $52,000
• Employer-sponsored medical, dental, and vision coverage
• Unlimited PTO plus 11 paid company holidays
• Eligibility to contribute to 401(k)
• Tailored professional development opportunities
• Access to Life Concierge services

About the Company

Oshi Health is a virtual digestive health practice on a mission to transform GI care. We combine compassionate, multidisciplinary care with innovative technology to help people with chronic digestive conditions get the answers and relief they deserve.