Managed Care Coordinator

Essential Job Responsibilities

• Obtains authorization for procedures as applicable to the patient’s insurance in a timely manner and based on urgency
• Works denials for unapproved pre-authorizations; follows up with insurance company to verify approval
• Works closely with Coding Department to ensure proper codes are authorized
• Communicates in an appropriate, professional manner with insurance associates, other CNSA staff, and patients or patient’s family members/contacts
• Updates database with authorization and managed care data
• Informs manager of critical situations concerning insurance plans
• Provides assistance to co-workers/satellite offices with education, problems, and questions concerning insurance and the authorization process
• Maintains strictest confidentiality and follows all CNSA guidelines regarding HIPAA regulations
• Performs at least minimum number of required tasks as assigned by management
• Completes additional tasks as assigned by management

Requirements

• Education: At least a High School Diploma or GED. Post-secondary education in any field is desirable.
• Job Related Experience: Minimum one year of pre-certification experience in a health care organization
• Other Requirements: Performance Requirements, Knowledge, Skills, Abilities, and Mental/Physical Requirements as described above