Authorization Coordinator

Authorization Coordinator

Sentara Health is looking to hire an Authorization Coordinator.

The Authorization Coordinator is responsible for review of clinical information received from Physicians and other Clinical providers ensuring clinical data is substantial enough to authorize services. Analyzes clinical information to ensure the services requested are authorized according to clinical protocols. Responsible for validation of member benefits for the services requested. Validates accuracy of insurance enrollment information in the system prior to authorizing services. Requires knowledge of managed care contracting, clinical protocols and clinical review requirements. Requires knowledge of regulatory and compliance requirements for government payers, self-funded and commercial payers. Ensures appropriate and accurate information is entered into claims system for processing payment. Related clinical experience as an LPN, such as experience in a physician office, acute care, managed care or clinic setting.

Education

• High School Diploma (required)

Certification

• Licensed Practical Nurse LPN (required)

Experience

• 3 years of related experience (required)
• Utilization Management experience (preferred)
• Diagnostic Imaging experience (preferred)
• Microsoft Suite (Word, Excel, Outlook) preferred
• Milliman experience (preferred)

Benefits

Medical, Dental, Vision plans

Adoption, Fertility and Surrogacy Reimbursement up to $10,000

Paid Time Off and Sick Leave

Paid Parental & Family Caregiver Leave

Emergency Backup Care

Long-Term, Short-Term Disability, and Critical Illness plans

Life Insurance

401k/403B with Employer Match

Tuition Assistance $5,250/year and discounted educational opportunities through Guild Education

Student Debt Pay Down $10,000

Pet Insurance Legal Resources PlanColleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.

Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.

In support of our mission "to improve health every day," this is a tobacco-free environment.

For positions that are available as remote work, Sentara Health employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.