Authorization Coordinator

Phoenix Heart Vein Vascular; Glendale (AZ); On-site; USD 42,000 - 64,000; Full time

Job summary

Phoenix Heart Vein Vascular is seeking an Authorization Coordinator to manage prior authorizations, verify patient insurance eligibility, and determine medical necessity before appointments. The role is fast-paced and requires keen attention to detail and clear communication with physicians, plans, and patients.

Key tasks include reviewing schedules, obtaining referrals, updating charts, and assisting billing with eligibility questions.

Qualifications

• 2+ years of related experience and/or training.
• In-depth knowledge and understanding of medical health insurance.
• Cardiology knowledge preferred, but not necessary.
• Diagnostic Authorization testing experience.
• Ability to remain calm under pressure while maintaining 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.
• Team-oriented approach and collaboration.
• Strong time management and organizational skills.
• Excellent verbal and written communication skills.
• Keen attention to detail and confidentiality.
• Proficient with PC-based software programs.

Responsibilities

• Review schedule for current date through five days out and add-on schedule daily to determine authorizations/referrals needed.
• Verify patient eligibility and benefits.
• Contact referring physicians, PCPs or health plans for referrals and authorizations.
• Contact patients for proper insurance information if needed.
• Handle calls regarding referral/authorization questions.
• Update patient accounts with correct information.
• Attach referrals/authorization information to service dates before filing claims.
• Assist billing with eligibility and authorization queries.
• Review EMR, email, fax and interoffice communications; respond within 24 hours.
• Inform manager of difficulties obtaining authorizations/referrals from carriers or physician offices.
• Inform manager of changes in authorizations/referrals by carriers/physician offices.
• Educate clinic staff on referral/authorization processes as related to positions.
• Notify Front Office manager if authorization or referrals are missing prior to patient visit.
• Review add-on schedule for next day needs.
• Scan referrals and authorizations into patient chart via paperclip.
• Document concisely in patient charts.
• Participation in new hire/annual training is required.
• Other tasks as assigned.

Skills

Attention to detail

Health insurance knowledge

Cardiology knowledge

Diagnostic authorization

Stress management

Professional attitude

Problem solving

Multi-tasking

Independent decisions

Team oriented

Work with hours flexibility

PC software proficiency

Interpersonal skills

Verbal communication

Written communication

Attention to detail

Education

High school diploma

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

Description

• 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