Pre-Authorization Coordinator

Job Responsibilities

• Sets up and documents patient demographic and insurance information.
• Verifies pre-certifications and obtains necessary upgrades.
• If pre-certification is not obtained for the next day, notifies the referring doctor’s office and contacts the patient to reschedule.
• Obtains financial clearance and/or prior balances from patients.
• Verifies patient insurance eligibility and obtains necessary pre-authorization numbers before the appointment date.
• Facilitates communication and collection of any fees due from patients.
• Documents and communicates with clinical staff, physicians, administrators, and patients regarding insurance problems and discrepancies.
• Scans documentation into the EMR system as necessary.
• Inputs and/or obtains authorizations/precertifications into and from online systems.
• Initiates and prepares written correspondence as needed.
• Attends workshops, seminars, and/or conferences to stay updated on industry standards and best practices.
• Disseminates information to colleagues and/or staff as appropriate.

Requirements

High School Diploma or equivalent required.

Approximately 2 years prior related experience in a customer service focused role.

Education

Knowledge of CPT, ICD9, and ICD10 coding.

Excellent communication skills (both verbal and written).

Professional appearance, punctuality, and a sense of urgency.

Ability to plan and prioritize work while responding to rapidly changing priorities.

Detail oriented.

Licenses and Certifications

N/A

Position Summary

Under direction, is responsible for the management of insurance verifications, eligibility and prior authorizations for services requiring referrals, including surgical procedures, visits and diagnostic testing.

Work Conditions/Physical Demands

Role may be remote EST daytime shift. Dedicated workspace conducive to a healthy work environment. Role may require the ability to work flexible hours, which may include early mornings and/or late nights.