Care Access & Authorization Specialist

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

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.