About the role
Description Job Summary
The position requires a strong understanding of insurance requirements including, but not limited to government, commercial, and workers’ compensation payors. The Authorization Coordinator is responsible for ensuring that all payor requirements are met to secure payment and provides patient cost estimates for procedures.
Detailed Responsibilities
Verifies Eligibility and Benefits – Coordinate with patient’s medical coverage to ensure coverage is active and obtain benefits associated with plan as it pertains to the practice; inputs all payor demographic data into EHR system
Obtains Referrals and Authorizations – Submit necessary requests for referrals and authorizations for all medical services including office visits, procedures, and DME; follows up with payors to ensure each patient scheduled has all items required to secure reimbursement; communicates with surgery scheduling regarding status of requests
Produces Cost Estimates – Based on benefits obtained, creates and distributes cost estimates for all scheduled procedures; assists with incoming cost inquiries.
Requirements
Education and Experience/Technical Skills
High school diploma or equivalent
Minimum of three years of work experience in a medical office business setting
Minimum of two years of experience with medical insurance
Proficient in MS Word, Excel, PowerPoint and Outlook
Must be organized and detail-oriented
Must possess excellent written and verbal communication skills
Must be able to multi-task in a fast-paced environment and meet deadlines
Knowledge of insurance terminology and concepts related to medical billing