Authorizations Coordinator

Job description

- Respond to incoming referrals, verify demographic information, and referral requirements to assess the organization's ability to meet patient needs prior to services. - Coordinate referrals between Primary Care Providers and specialists to ensure all referrals meet payer-specific guidelines (e.g. HMO, WellMed, Medicare Advantage plans) - Work with insurers to verify patient eligibility and benefits, and expediently complete prior authorizations using insurance portals or calling insurers directly. Ensure authorization is approved in a timely manner by following up with insurers and providing additional information - Collaborate with billing department on account updates and authorization activity. Review authorizations to ensure proper coding (including modifiers) and coverage. Assist with denials by obtaining clinical information, ICD-10 coding, or other details to correct errors. - Be responsible for handling multiple prior authorizations simultaneously and create processes to ensure top of the line performance. Conduct courtesy follow-ups, participate in training, and ensure compliance with policies and values. - Maintain charts, records, and databases of patient referral auth...