Authorization Coordinator

City/State

Harrisonburg, VA

Overview

Work Shift

First (Days) (United States of America)

Sentara Rockingham Memorial Hospital, located in Harrisonburg, VA, is hiring a Remote Authorization Coordinator II- Full Time Day Schedule

Sentara RMH Medical Center, a Magnet designated hospital located in Harrisonburg VA, serves a seven-county area with a population of 218,000 residents. The 238-bed community hospital partnered with the Sentara Healthcare system in May of 2011. Sentara RMH features the RMH Hahn Cancer Center, a state of the art center equipped with the latest cancer fighting technologies available in the nation.

Benefits: Sentara offers an attractive array of full-time benefits to include Medical, Dental, Vision, Paid Time Off, Sick, Tuition Reimbursement, a 401k/403B, 401a, Performance Plus Bonus, Career Advancement Opportunities, Work Perks, and more.Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth.

Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve

Talroo - Allied Health, coordinator, insurance verification, registration, billing

Job Summary

Responsible for reviewing clinical information obtained from physicians, department queues and other clinical providers, ensuring data is substantial enough to authorize services for appropriate visit account types. Analyzes clinical information to ensure the services requested are authorized according to clinical and payer protocols. Ability to properly obtain insurance eligibility, member benefits, obtain authorizations and complete pre-registration for the services requested. Validates accuracy of active insurance enrollment in the system prior to authorizing services.

Responsible for assisting with covering work for other team members due to staff shortage, workload and or as deemed necessary my leadership.
Responsible for assisting in managing team projects, collaborating with education and leadership on opportunity identification, resolutions, and implementation.

Accurate assessment and review of patient treatment plans is required to include location and duration of care. Responsible for assisting with covering work for other team members due to staff shortage, workload and or as deemed necessary my leadership. Responsible for assisting in managing team projects, collaborating with education and leadership on opportunity identification, resolutions, and implementation. Must demonstrate the ability to be a critical thinker and the ability to collaborate positively with peers, leaders and department team members and leaders to fully support team and drive positive results demonstrated via key performance indicators. Required to stay up to date on payer authorization and benefit policies.

Must demonstrate the ability to understand complex payer policy and treatment plans to secure authorization timely with correct documentational and with the appropriate payer requirements in a timely manner. Required to demonstrate excellent customer service skills with all customers to include patients, piers, department team members and leadership. Ability to act as a liaison between patients, physicians, clinical department, and insurance company.

Medical terminology and ICD-10 knowledge required

Responsible to secure semi complex, difficult authorization work as determined by payer behavior, time needed to authorize, opportunity research and key performance indicators. Required to have knowledge in modality and payer behavior. Accountable to problem solve, investigate and help resolve problems for work assignment. Must collaborate effectively with internal and external teams to reach desired results as determined by key performance indicators and leadership.

Qualifications:

HS - High School Grad or Equivalent

Certified Healthcare Access Associate (CHAA) - Certification - National Association of Healthcare Access Management (NAHAM), Certified Healthcare Access Manager (CHAM) - Certification - National Association of Healthcare Access Management (NAHAM)

Health Insurance Authorizations, Health Insurance Verification, Registration/Billing

Skills

Sentara Healthcare prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.

Per Clinical Laboratory Improvement Amendments (CLIA), some clinical environments require proof of education; these regulations are posted at ecfr.gov for further information. In an effort to expedite this verification requirement, we encourage you to upload your diploma or transcript at time of application.

In support of our mission ‘to improve health every day,‘ this is a tobacco-free environment.

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