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Authorization Coordinator

Company:
CoreTechs Inc.
Location:
Lafayette, California, 94549, United States
Posted:
November 08, 2018

Description:

Duties:

• The authorization coordinator position is responsible for performing the appropriate processes to verify patient eligibility, ensure insurance coverage, and determine if prior authorization is needed for said order.

• If needed, obtain authorization and document in the patient electronic medical record.

• This position will facilitate responses to patient and provider inquiries regarding authorizations within turnaround standards.

• Monitor and resolve orders in a timely manner

• Monitor daily urgent and pending PA's to ensure timeliness standards are met and customer service is maximized according to standard workflows

• Ensure completeness and accuracy of PA's by confirming CPT, ICD and/or HCPCS codes, requested provider, and/or place of service

• Obtain added medical information from providers and/or office staff as necessary for incoming PA's

• Process per standard work Process per health plan contracts and requirements

• Provide necessary medical information to obtain final determinations when required.

• Research all no authorization denials and submit for retro authorizations

• Obtain appropriate approval for requested orders

• Maintain accuracy with attention to detail in each PA request

• Proactively research problem issues related to own work, and recommend resolutions

Skills:

• Associate's or Bachelor's degree

• Experience working with electronic health records

• Experience working with insurance prior authorizations and referrals

• Knowledge of ICD, CPT, and HCPCS coding

• Knowledge of Medical Terminology

• Proficient with MS Word and Excel

• Recent experience working in a health care setting with insurance verification