Prior Authorizations Coordinator

2 weeks ago


Chula Vista, United States Neurology Clinics Full time
Job DescriptionJob DescriptionBenefits:
  • 401(k)
  • 401(k) matching
  • Dental insurance
  • Opportunity for advancement
  • Paid time off
  • Training & development
  • Vision insurance

The Neuron Clinic is a busy outpatient neurology practice with locations in Chula Vista, Temecula, and San Marcos, CA. We are passionate about delivering high-quality patient care. We accept Medicare, Medi-Cal, Tricare, and most HMOs and commercial PPOs. We are seeking a healthcare professional that is passionate about quality care and making a difference in our patients lives.

Why Join the Team?
  • Competitive Compensation
  • Generous Health Insurance Coverage: Medical & Dental
  • Retirement Plan - Dollar for Dollar match
  • Paid Vacation Accruals
  • Paid Holidays
  • Paid training
  • Work alongside extremely talented highly specialized doctors
  • Excellent Work-life Balance
Summary
The Prior Authorizations Coordinator is responsible for submitting, coordinating, distributing, and following up on outbound referral orders placed by internal physicians. They must use their interpersonal skills to resolve scheduling and access related issues as well as effectively collaborate with patients, team members, physicians and other stakeholders to maintain a high level of efficiency and quality care. Must have strong communication skills, providing patients with appointments and information about their appointments. The Prior Authorization Coordinator is responsible for obtaining insurance approvals to ensure continuity of care for our patients.

Essential Duties and Responsibilities

  1. Works with staff to guarantee timely processing of all outgoing referrals; participates in Prior Authorizations workflows as directed by supervisor or as needed for staff coverage
  2. After submitting authorizations, performs data entry into productivity tracker and EHR; checks status of submitted authorizations at appropriate interval; contacts patients upon approval for external authorization to inform them of approval; contacts patients to inform them of authorization denials
  3. Accesses working directory of external providers and facilities to refer to; guarantees that patients are referred to the appropriate facilities at the appropriate level of care for the appropriate order
Preferred Education and Experience
  1. Education and/or degree in healthcare preferred
  2. At least 1 year of experience as a Prior Authorizations Coordinator or related role with robust knowledge of local insurances, authorization requirements, and referrals management preferred
Special Conditions of Employment
  1. Furnish proof of COVID-19 vaccination
Knowledge Skills and Abilities
  1. Knowledge of medical terminology and procedural coding; includes ability to interpret insurance information.
  2. Knowledge of ICD-10 and CPT codes
  3. Experience with insurance plans, third-party payer practices and guidelines, and pre-certification and referral management for insurance plans.
  4. Experience working in a metric-driven work environment.
  5. Excellent time management skills, be highly organized, self-motivated.
  6. Maintain a high level of productivity and confidentiality.
  7. Strong knowledge of computer-based systems such as Excel, Word, and the Internet with the ability to quickly learn new systems.
  8. The ability to follow through timely on tasks is essential.
  9. Strong interpersonal skills to work effectively with people of diverse cultural, educational, economical, and social backgrounds.
  10. Bilingual English/Spanish preferred
Schedule
  • 8 hour shift
  • Monday - Friday



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