Prior Authorization Specialist

Baptist; Memphis (TN); On-site; USD 38,000 - 52,000; Full time

Job summary

The Authorization Coordinator at Baptist is responsible for documenting and transmitting information vital to utilization review and supporting Baptist’s reimbursement strategy. Specifically, the managed care techniques used focus on prior authorization for services using evidence based criteria, coordinating between payer, business office and UR Team.

Key tasks include payer communications, updating the EMR with review dates, denial management, and scheduling peer-to-peer reviews when

Qualifications

• 2 years’ clerical/support experience in a medical environment.
• Strong data entry accuracy and attention to detail.
• Proficient in Microsoft Office and basic computer skills.

Responsibilities

• Communicates incorrect payer with patient access
• Communicate with Utilization Review Nurse
• Works assigned queues in the electronic medical record
• Documents next review dates in the electronic medical record
• Documents and updates authorized or denied information on auth/cert screen in the electronic medical record
• Schedules peer to peer when indicated
• Completes assigned goals

Skills

Microsoft Office

Medical terminology

Data entry

Education

High School Diploma

Job description

The Authorization Coordinator at Baptist is responsible for documenting and transmitting information vital to utilization review and supporting Baptist’s reimbursement strategy. Specifically, the managed care techniques used focus on prior authorization for services using evidence based criteria, coordinating between payer, business office and UR Team.

Key tasks include payer communications, updating the EMR with review dates, denial management, and scheduling peer-to-peer reviews when