Prior Authorizations Specialist - Pulmonary

Job Summary

Authorization Coordinators in HHCMG Pulmonary Sleep Centers are responsible for obtaining authorizations for Home Sleep Testing. They also manage the entire home sleep testing process, including scheduling appointments, preparing and setting up devices, educating patients, troubleshooting, and ensuring accurate data downloads and transfers for clinical interpretation.

This role supports efficient access, enhances patient experience, and ensures high-quality diagnostic testing within the Sleep Medicine program. They manage WQ’s to ensure orders for testing are processed properly and in a timely manner to obtain authorizations and schedule appointments for patients to pick up equipment for test. They provide patients with instructions and demonstrations on how to properly utilize the equipment for the test. They upload data for all completed tests through appropriate software, ensuring all test reports are accurately uploaded and routed to the correct physician for scoring and interpretation. They collaborate with the team of physicians to address any unsuccessful collected data, determining if a patient needs to repeat the test. They verify insurance eligibility, benefits, and obtain all necessary prior authorizations, insurance approvals, and copays. They prepare, configure, and assign HST units based on provider orders, ensuring all devices are charged, calibrated, cleaned, and ready for use. They maintain inventory of sensors, belts, and device supplies.

Qualifications

• Minimum of 1 year as a medical receptionist or previous care coordination experience
• Direct customer service in the medical field