Authorization Coordinator, Insurance Services

Essential Accountabilities

Reflects the jobs main responsibilities and is not intended to be an exhaustive list of all duties performed; therefore its content does not restrict managements right to assign or reassign duties and responsibilities to individuals in this job.

• Researches and processes prior authorization requests.

• Verifies eligibility and benefits of members.

• Performs data entry prioritizes and processes auto authorizations.

• Monitors and follows-up on open or pended authorizations.

• Enters demographic information into the system and updates information.

• Prepares and maintains logs and reports.

• Responds to and processes urgent/stat authorization requests.

• Maintains confidentiality and discretion in use of member information.

• Performs other job-related duties as assigned.

Knowledge Skills and Abilities

• Knowledge of HMO commercial line of business.

• Knowledge of HMO prior authorization requests referral process eligibility verification and health plan benefits.

• Ability to operate office equipment (e.g. telephone fax computer scanner etc.).

• Skills in preparing and maintaining records writing reports and responding to correspondence.

• Thorough and prompt follow-up up to resolution.

• Excellent oral and written communication skills with proper use of grammar spelling and punctuation.

• Ability to read understand and follow oral and written instructions.

• Ability to multi-task work with frequent interruptions and meet deadlines.

• Ability to establish and maintain effective working relationships.

• Detailed and goal oriented.

• Ability to work effectively in a team environment.