Prior Authorization Coordinator

Prior Authorization Coordinator

In this position you will determine client benefits and obtain and track client authorizations for services. People who are successful in this position will have a high attention to detail and be able to work in a fast-paced environment. Prior Authorization Coordinator is responsible for verifying patient-eligibility, coordinating benefits, and facilitating insurance coverage, as well as addressing patients' concerns regarding authorization and turnaround.

Full Time: M-F 8:00 AM - 5:00 PM

Essential Functions/Performance Expectations

• Contacting insurance companies via phone and/or web to verify clients medical benefits
• Analyzing reports, tracking, and obtaining necessary authorizations for all services
• Answering insurance coverage and prior authorization questions from providers, families, and other Revenue Cycle members as needed
• Working with Microsoft office and Electronic Health Records
• Performing other duties to support Revenue Cycle operations as needed
• Ensure payment for services by verifying benefits with insurance provider.
• Document all prior authorization information including approval dates, billing units, procedure codes, and prior authorization number in patient profile
• Review insurance denials and submit appeals (as permitted by payor)
• Schedules surgeries by making arrangements with the surgical center; verifying times with patients; and preparing charts and pre-admission and consent forms.
• Perform all other duties as assigned

Education And Experience

• Experience with EMR (electronic medical records), medical terminology
• 1+ year experience working with medical insurance and/or prior authorizations
• Excellent verbal and written communication skills
• Ability to work independently
• Strong passion for serving our clients
• Strong decision making/problem solving skills

Physical Requirements

• Stand, walk, sit, stoop, reach, lift, see, speak and hear. Lifting is limited to 35 lbs. for clinical staff and to 50 lbs. for non-clinical staff. The individual must use an assisted-lift device or get another individual(s) to assist with the lift that is over these maximum limits.
• Ability to work flexible schedules
• Ability to work under stress