Prior Authorization Coordinator
Prior Authorization Coordinator
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Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
Were excited to highlight a key position on our team! This role plays a vital part in ensuring seamless patient care by obtaining prior authorizations from third-party payors for all hospital admissions outpatient procedures surgeries and interventional pain proceduresboth in-office and outpatient. Acting as a liaison between physicians and insurance providers this position helps streamline the approval process and supports timely effective treatment for our patients.
The role is currently hybrid following six months of onsite training; however this is subject to change.
Education/Experience:
- High School graduate.
- Minimum of 1 -2 years of experience in a medical secretary/scheduling role or related position
Skills:
- Practical knowledge of neurosurgical procedures and medical office processes
- Working knowledge of CPT and ICD coding
- Demonstrates excellent customer service
- Ability to manage and prioritize multiple tasks in a fast-paced environment
- Strong problem-solving problem-prevention and decision-making skills
- Ability to convey empathy
- Excellent oral and written communication skills
- Ability to maintain composure and restore calm in a stressful situation
- Uses good judgment and diplomacy when dealing with others
- Desire and ability to work in a team environment
- Computer proficient with the ability to learn multiple software applications
- Familiar with insurance company requirements and payor medical policies
- Ability to work with minimal supervision
Essential Functions:
- Help develop and maintain a corporate culture that supports the mission and values of Mayfield Clinic.
- Initiate and document prior authorization for all third-party payors for patients undergoing a procedure or hospital admission.
- Adhering to standardized processes for documentation and follow-up.
- Work collaboratively with the surgery scheduler/medical secretary to ensure information is complete and accurate.
- Record all prior authorization phone calls documents and authorization numbers in the surgical worksheet. Scan or copy/paste online authorizations into the EHR.
- In the event of a claim denial due to prior authorization provide follow-up and documentation to Revenue Cycle Management to support an appeal.
- Obtain prior authorization and/or schedule testing (eg MRI MRA CT) on an as-needed basis.
- Work in concert with the Revenue Cycle Management Department to reduce and/or minimize third-party payer denials for prior authorizations or pre-determined issues.
Required Experience:
IC
Employment Type
Full Time
