Authorization Coordinator

Experience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career with an organization committed to delivering respectful, compassionate care, and where the unique and intrinsic worth of each individual is recognized.

About the role

Seeking an Authorization Coordinator responsible for timely and accurate processes associated with pre-certification, obtaining and certifying authorizations, and assisting with appeals of authorizations. Collaborates with the referral coordinator to ensure all approvals are obtained.

Responsibilities

• Review and complete prior authorizations to ensure timeliness of appointments, testing, procedures, and claims filing.
• Obtain clinical information (including medical history, diagnosis, and relevant lab reports) necessary to complete prior authorizations, including insurance requirements.
• Follow criteria for all services requiring prior authorizations and submit requests in a timely manner.
• Ensure appropriate documentation is entered in the standard billing system and all needed systems.
• Track status of prior authorizations via payor authorization portals.
• Review denied claims for clinical accuracy, correct errors for claims resubmission.
• Support patient experience through patient-centered communications demonstrating excellent customer service skills.
• Communicate with insurance companies to pre-certify, authorize, or amend services.
• Recommend new approaches, policies, and procedures to influence continuous improvements in department efficiency and services.
• Actively participate in problem identification and coordinate resolution between appropriate parties.
• Utilize appropriate communication systems to facilitate communication with hospital partners.
• Research patient visit history to ensure compliance with payor-specific payment window rules; communicate patient payment responsibilities and guide them through needed steps.
• Perform other related job functions as assigned.
• Practice and adhere to the Code of Conduct and Mission and Value Statements.

Qualifications

• Education: High School Diploma or GED equivalent required.
• Experience: One year of related experience with medical insurance plans and/or Medicare benefits verification required. One year of medical clinic, urgent care, or hospital care setting experience preferred. Prior authorization experience preferred.

Benefits

College Park Family Care offers a total rewards package that supports the health, life, career, and retirement of our colleagues. The available plans and programs include:

• Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health, and telemedicine services.
• Wellbeing support, including free counseling and referral services.
• Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage, and leaves of absence.
• Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support, and financial wellbeing counseling.
• Education support through tuition assistance, student loan assistance, certification support, dependent scholarships, and a partnership with Galen College of Nursing.
• Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection, and consumer discounts.

Note: Eligibility for benefits may vary by location.