Authorization Coordinator

Phoenixheart; Glendale (AZ); On-site; USD 38,000 - 54,000; Full time

Job summary

Phoenixheart in Arizona is seeking an Authorization Coordinator to manage prior authorizations for diagnostic tests, verify eligibility and benefits, and ensure medical necessity requirements are met before patient appointments. The role includes reviewing schedules, contacting physicians and health plans, updating EMR with authorization data, and supporting billing with eligibility questions.

Strong attention to detail and the ability to work calmly under pressure are essential.

Qualifications

• 2+ years of related experience and/or training.
• In-depth knowledge and understanding of medical health insurance.
• Cardiology knowledge preferred, but not required.
• Must have Diagnostic Authorization testing experience.
• Ability to stay calm and professional in stressful situations while ensuring customer satisfaction.
• Professional attitude and reliability.
• Ability to solve problems, prioritize and multitask in a deadline-driven environment.
• Ability to make independent decisions with minimal supervision.
• Willingness to work outside core business hours as needed.
• Able to work in a team environment with positive interactions.
• Strong time management and organizational skills.
• Excellent interpersonal, verbal and written communication skills.
• Keen attention to detail and ability to handle confidential information.
• Proficient with PC-based software programs.

Responsibilities

• Review daily appointment schedule for today through five days out and coordinate authorizations/referrals.
• Verify patient eligibility and benefits.
• Contact referring physicians, PCPs or health plans for paper referrals and authorizations.
• Contact patients for insurance verification when needed.
• Handle calls about referrals/authorizations from check-in or patients.
• Update patient accounts with authorization-related information.
• Add referrals/authorization data to dates of service before claim filing.
• Assist billing with eligibility and authorization questions.
• Review EMR, email, fax and interoffice communications daily; respond within 24 hours.
• Inform manager of difficulties obtaining authorizations or referrals.
• Inform about insurance changes affecting authorizations/referrals.
• Participate in referral/authorization training for clinic staff.
• Notify Front Office if authorization/referral not received before visit.
• Review add-ons for the next day before leaving.
• Scan referrals and authorization documents into patient charts.
• Document concisely in patient charts.
• Participate in new hire/annual training.
• Perform other assigned tasks.

Skills

Medical insurance knowledge

Attention to detail

Customer service

Communication skills

Time management

Organizational skills

Teamwork

Problem solving

Multitasking

Confidentiality

PC proficiency

Education

High school diploma or equivalent

Tools

EMR systems

Job description

Description

The Authorization Coordinator is a fast-paced position that requires exceptional attention to detail and a thorough understanding of insurance plans, networks, and authorization requirements. The Authorization Coordinator secures prior authorization for diagnostic tests, verifies insurance eligibility, and benefits and checks for certain medical necessity requirements prior to the patient appointment.

• Reviewing current appointment schedule for current date through five days out and the add‑on schedule daily for authorizations/referrals needed
• Verifying patient eligibility and benefits
• Contacting referring physicians, PCP’s or health plans for paper referrals and authorizations.
• Contacting patients for proper insurance if needed.
• Handling calls from check in desk or patients regarding referral/authorization questions
• Update patient accounts with appropriate information
• Add referrals/authorization information to specific dates of service before claim filing
• Assist billing personnel with questions regarding eligibility, authorizations and referrals
• Review EMR desktop, email, fax and interoffice communication throughout the day. Responds to all within 24 hours of receipt
• Inform manager of difficulties in obtaining authorizations/referrals from insurance carriers or physician offices
• Informs manager of any changes made by insurance carriers and/or physician offices in obtaining authorizations and/or referrals
• Participates in the referral/authorization education of clinic personnel as it relates to their positions
• Notifies Front Office manager when Phoenix Heart has not received authorization or required referrals prior to patient’s visit
• Prior to leaving for the day, review add‑on schedule to see what is needed for the next day
• Scan referrals, authorizations and other insurance related paperwork to import into patient’s chart under the paperclip
• Perform concise and thorough documentation in patient’s charts
• Participation in new hire/annual training is a condition of employment
• Other tasks as assigned

Requirements

Qualifications

Desired Skills and Experience:

• 2+ years of related experience and/or training
• Must have in-depth knowledge and understanding of medical health insurance
• Working knowledge of cardiology preferred, but not necessary
• Must have Diagnostic Authorization testing experience
• Must have the ability to effectively deal with stressful situations in a calm and productive manner, while maintaining the highest degree of customer satisfaction
• Professional attitude
• Ability to solve problems, prioritize and multi‑task in a deadline driven environment
• Ability to make independent decisions regarding matters of significance
• Work with little to no supervision
• Ability to work outside core business hours as needed
• Able to work in a team environment and interact positively with team members
• Goal oriented, with excellent time management and organizational skills
• Excellent interpersonal skills, with ability to interact effectively and work efficiently with people at all levels in an organization internally and externally
• Excellent verbal & written communication skills
• Keenly attentive to detail
• Ability to keep sensitive information confidential
• High level of proficiency with PC based software programs

Education

High school diploma or equivalent