Authorization Coordinator

Phoenix Heart; Glendale (AZ); On-site; USD 42,000 - 62,000; Full time

Job summary

Phoenix Heart is seeking an Authorization Coordinator to manage prior authorizations for diagnostic tests, verify insurance eligibility and benefits, and ensure required referrals are in place before patient visits.

The role requires meticulous attention to detail, strong communication skills, and the ability to work with physicians, health plans, and patients. Experience with medical accreditation and EMR systems is preferred. This is a fast-paced, in-office position in a clinical setting.

Qualifications

• 2+ years of related experience and/or training.
• In-depth knowledge and understanding of medical health insurance.
• Working knowledge of cardiology preferred, but not required.
• Diagnostic authorization testing experience.
• Ability to handle stressful situations with professionalism and provide excellent customer service.
• Strong problem-solving, prioritization and multi-tasking abilities.
• Ability to work with minimal supervision and outside core hours when needed.
• Excellent communication, both written and verbal, with all levels of staff and patients.

Responsibilities

• Review appointment schedule for the current date through five days out, and manage add-on authorizations/referrals daily.
• Verify patient eligibility and benefits.
• Contact referring physicians, PCPs or health plans for referrals and authorizations.
• Contact patients for insurance verification when needed.
• Handle inbound/outbound calls regarding referrals/authorizations.
• Update patient accounts with relevant information.
• Add referrals/authorization details to service dates before claims are filed.
• Assist billing with eligibility and authorization questions.
• Review EMR, email, fax, and interoffice communications; respond within 24 hours.
• Inform manager of any difficulties obtaining authorizations/referrals from carriers or physician offices.
• Notify changes by carriers/physician offices in authorizations/referrals.
• Participate in referral/authorization education for clinic staff.
• Notify Front Office if authorization or referrals are missing before patient visits.
• Before leaving, review add-on schedule for the next day.
• Scan referrals/authorizations into patient charts; document thoroughly.
• Participate in new hire/annual training as required.
• Other tasks as assigned.

Skills

Medical insurance knowledge

Diagnostic authorization experience

Interpersonal communication

Multitasking

Problem solving

Attention to detail

Education

High school diploma or equivalent

Tools

PC software proficiency

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