Care Coordination Authorization Specialist

GPH - North Platte NE Hospital Corp DBA Great Plains Health; United States; On-site; USD 40,000 - 65,000; Full time

Job summary

Great Plains Health in North Platte, NE seeks an Authorization Specialist to join the Financial Counseling team. You will coordinate care across the health care continuum, evaluate medical necessity, and assist with pre-authorizations and payer communications to support patient care and billing accuracy.

The role requires understanding of medical terminology and payer requirements, with a focus on effective collaboration with physicians, nurses, schedulers and patient financial services to

Qualifications

• Education: HS Diploma or equivalent; related degrees preferred.
• Knowledge of Medical Terminology, CPT and ICD codes required.
• Credentials: None.

Responsibilities

• Coordinate and manage care across the health care continuum.
• Evaluate medical necessity and appropriateness of care.
• Communicate plan across the continuum of care to payers and team.
• Assist with pre-authorizations and managed care concepts.
• Work on denials to overturn them.

Skills

Medical terminology

Denials management

Communication

Education

High School Diploma or equivalent

Tools

CPT and ICD codes

Job description

Great Plains Health in North Platte, NE seeks an Authorization Specialist to join the Financial Counseling team. You will coordinate care across the health care continuum, evaluate medical necessity, and assist with pre-authorizations and payer communications to support patient care and billing accuracy.

The role requires understanding of medical terminology and payer requirements, with a focus on effective collaboration with physicians, nurses, schedulers and patient financial services to