Authorization Coordinator
- Job Title
- Authorization Coordinator
- Job ID
- 27703998
- Location
- Murrieta, CA 92563
- Other Location
- Description
-
Purpose:
This position is responsible for reviewing the physician’s daily schedule and obtaining verification of patients’ insurance benefits for their scheduled visits. They will also obtain authorization for all requested procedures, tests, drugs, etc. The Authorization Coordinator may be asked to perform other duties if necessary & must be knowledgeable of a variety of Insurance Plans and Policies.
Responsibilities/Essential Functions (other duties as assigned):- Receives chemotherapy orders and reviews for compendia compliance, submits for authorization.
- Ensures compendia compliance and obtains all required authorization and referral information for patients’ treatments.
- Receives authorization for in-house and outpatient procedures and documenting it in the patient medical record.
- Communicates effectively with the Billing and Office Managers as well as billing and clinical staff to ensure appropriate treatment can be provided, claims can be processed accurately and timely payment received.
- Maintains detailed notes in patients’ electronic records.
- Reviews schedules daily and ensures appropriate insurance and authorization has been obtained and documented.
- Maintain a high level of confidentiality for patients in accordance to HIPAA standards.
- Ensures patients are contacted prior to appointments to inform them of treatment schedule changes if necessary and when appropriate.
- Become familiar with up to date NCCN guidelines.
- Effectively completes other duties and projects as assigned.
Experience, Qualifications/Education:
- High School Diploma or equivalent required
- 2-3 years’ experience
- Clinical business training preferred
- Knowledge of computer/telephony support, preferably in a health care environment
- Strong customer service background, preferably in health care environment
- Excellent verbal communication skills
- Competence with computer processing functions and other standard office equipment
- Ability to manage and prioritize multiple tasks
- Ability to calmly and professionally resolve customer issues with diplomacy and tact
- Ability to work independently with minimal supervision
- Strong organizational skills
Working Conditions:
- This position functions primarily indoors in a medical / business environment. Employee may be subject to blood borne pathogens, radiation, bio waste and other medically-related factors, with exposure to moderate noise levels.
- Visual acuity to read and compute screen and paper documents; close and distance vision, peripheral vision depth perception, ability to adjust focus; hearing acuity to converse with staff and customers; ability to walk, stoop, bend, kneel, and lift and move 25 pounds on a regular basis; ability to sit for hours at a time. Employee will be exposed to moderate noise levels, interruptions, and occasionally asked to work evening and weekends as needed.
