Authorization Coordinator

Phoenix Heart; Glendale (AZ); On-site; USD 42,000 - 54,000; Full time

Job summary

Phoenix Heart is seeking an Authorization Coordinator to secure prior authorizations, verify insurance eligibility and benefits, and ensure authorizations/referrals are in place before patient appointments.

You will review schedules, communicate with physicians and plans, assist billing, and maintain accurate documentation throughout the process.

Qualifications

• 2+ years of related experience and/or training.
• In-depth knowledge of medical health insurance.
• Experience with diagnostic authorization testing preferred.
• Ability to work under pressure while maintaining customer satisfaction.
• Strong written and verbal communication skills.
• Proficient with PC-based software and EMR systems.

Responsibilities

• Review schedule to identify authorizations/referrals needed for current date through five days out.
• Verify patient eligibility and benefits.
• Contact referring physicians, PCPs, or health plans for authorizations.
• Notify patients about required insurance information.
• Assist billing with eligibility and referrals questions.
• Update patient accounts and add referrals/authorizations to dates of service.
• Document thoroughly in patient charts and review communications daily.
• Escalate authorization issues to the manager as needed.
• Participate in clinic-wide referral/authorization education.
• Perform other tasks as assigned.

Skills

2+ years experience

Medical insurance knowledge

Authorizations experience

Ability to multi-task

Stress management

Detail oriented

Communication skills

Problem solving

Team collaboration

Confidentiality

PC software proficiency

Time management

Independent decision making

Education

High school diploma or equivalent

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