Prior Authorization Coordinator

Description

StatCare is a private Pulmonary, Critical Care, Sleep, and Hospitalist medical practice dedicated to providing high-quality inpatient & outpatient care to patients throughout East Tennessee. Our physicians and advanced practice providers are committed to delivering patient-centered care to ensuring continuity, expertise, and compassion at every stage of hospitalization. StatCare strives to work collaboratively with hospital partners, nurses, and support staff, improving health outcomes and elevate the standard of care for the communities we are proud to serve.

Prior Authorization Coordinator is responsible for securing prior authorizations for diagnostic testing, including but not limited to CT scans, MRIs, and other procedures, ensuring patients receive timely access to care while minimizing delays in treatment. The ideal candidate will work closely with providers, patients, insurance companies, and diagnostic facilities to ensure all authorizations are obtained accurately and efficiently.

Examples of Duties : (List does not include all duties assigned)

• Obtain prior authorizations for diagnostic testing (CT scans, MRIs, etc.) and pulmonary-related procedures.
• Verify insurance coverage and requirements before submitting authorization requests.
• Communicate with insurance companies, providers, and diagnostic centers to facilitate approvals.
• Track and follow up on pending authorizations to ensure timely completion.
• Document all authorization activities in the patient's medical record and maintain accurate records.
• Notify providers and patients promptly of authorization status, including denials and next steps.
• Collaborate with clinical and administrative staff to prevent delays in patient care.
• Assist with appeals or re-submissions when necessary.
• Maintain confidentiality and compliance with HIPAA and all applicable regulations.

KNOWLEDGE, SKILLS, AND ABILITIES

• Minimum of 1-2 years of prior authorization, insurance verification, or medical office experience (pulmonary or specialty office experience preferred).
• Knowledge of insurance guidelines, medical terminology, and diagnostic testing procedures.
• Proficiency with electronic health records (EHR) and Microsoft Office Suite.
• Excellent communication and customer service skills.
• Ability to work independently and as part of a team in a fast-paced environment and multi-task.
• Ability to apply policies and principles to solve everyday problems and deal with a variety of situations.
• Ability to work effectively with physicians, patients, staff and the public.
• Ability to establish priorities and coordinate work activities.

Educaton: High School Diploma or GED required.

WORK LOCATION: In-Person, Full-Time, Monday - Friday

BENEFITS:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

StatCare symbolizes excellence, every patient, every time. Our success is built on a strong foundation of high-quality patient-centered care, physician ownership, collaborative relationships, and entrepreneurial spirit. We foster a culture rooted in professionalism, trust, and communication - values that extend across our internal teams and our external relationships with healthcare partners.