Prior Authorization/Orders Coordinator

Job description

At Mahaska Health the primary role of the Prior Authorization/Orders Coordinator will be responsible for verifying if a prior authorization is needed or has been obtained, the proper authorization numbers are in the EHR system, and all outpatient orders have been checked for medical necessity and prior authorized if necessary. Essential job responsibilities include but are not limited to, Job Requirements include but are not limited to, - All orders will be checked for completeness and accuracy. Missing information will be obtained by this position. - A BOR Request will be sent for any/all providers not already in the Mahaska Health system. This will verify them for a valid license, and any suspensions, and to confirm their National Provider Identifier (NPI), address, phone number, and fax number. - All Medicare orders will be run through compliance validating software to check for medical necessity. If a test does not meet medical necessity, the provider will be contacted for additional documentation. - Responsible for obtaining and ensuring prior authorization is completed and approved prior to the test being scheduled. - Will reach out to the patient to discuss the need to obtai...