Authorization and Benefits Coordinator

Duties

• Utilizes the Managed Care Work list to track receipt, delays and completion of requests, to prioritize requests and obtain authorizations at minimum one week prior to scheduled date of service, as possible
• Works Eligibility and Authorization reports for the Diagnostic Center
• Tracks activity to identify carrier trends
• Makes recommendations regarding trends to the department director
• Reviews and works Denial Reports for the Diagnostic Center
• Updates Diagnostic Center patient accounts with the correct insurance information
• Independently assesses carrier trends, on a proactive basis and communicates information to appropriate personnel
• Facilitates communication among parties impacted by coding related matters to produce a timely and satisfactory solution
• Stays informed of insurance requirements and industry related news/policy changes as relate to coding
• Responds to questions from patients in a courteous and professional manner
• Completes assigned reports and/or projects within deadlines
• Maintains a positive & cooperative working relationship with internal and external customers
• Communicates in a professional manner with staff in medical offices and co-workers
• Stays informed of current insurance carrier requirements regarding pre-authorization of service
• Performs other duties as may be assigned cheerfully and willingly

Requirements

• Exposed to frequent and constant interruptions in daily functions/schedule
• Must be available to customers and staff throughout the day
• Required to work extended hours to meet department needs

Qualifications

• Minimum education requirement is high school diploma or GED
• Minimum of 2 years experience in healthcare insurance area
• Display customer services skills, strong interpersonal skills, close attention to detail, and excellent verbal and written communication skills
• Be able to work hours necessary to accurately and thoroughly perform duties
• Proficient in use of the following computer software: Microsoft office, EMR

Skills

• Close attention to detail
• Excellent verbal and written communication skills
• Proactive trend identification and reporting
• Effective communication and collaboration skills
• Computer proficiency (Microsoft Office, EMR)

Benefits

• Comprehensive benefits package including medical, dental, vision, 401(k), life/AD&D, disability, accident, critical illness, hospital indemnity, legal, identity theft, pet, and tickets at work