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Patient Authorization Coordinator
2 months ago
Location: On-Site Only
Role Summary: Under general oversight, the Patient Authorization Coordinator is responsible for evaluating patient documentation in alignment with reimbursement protocols.
Key Responsibilities:
- Secure necessary pre-authorizations and exceptions to prevent delays in treatment reimbursements.
- Investigate denied claims and explore alternative funding options for treatment.
Essential Duties:
- Assess, process, and verify the medical necessity for each patient in relation to established care pathways.
- Engage with nursing and medical personnel to communicate any limitations or specific requirements dictated by insurance policies.
- Provide timely updates to physicians and management regarding documentation discrepancies and payer-related issues concerning uncovered services.
- Revise coding and payer guidelines for clinical teams.
- Monitor care pathways and execute various administrative tasks as required.
- Facilitate insurance authorizations and pre-certifications.
- Investigate additional or alternative funding sources for non-covered chemotherapy treatments to mitigate payment denials.
- Comply with confidentiality, state, federal, and HIPAA regulations concerning patient records.
- Perform other assigned duties as necessary.
About TEKsystems:
We are partners in transformation, assisting clients in realizing ideas and solutions to leverage new opportunities. Our team of 80,000 professionals collaborates with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe, and Asia. As a leader in Full-Stack Technology Services and Talent Services, we work alongside innovative leaders to drive meaningful change. This is the essence of true partnership. TEKsystems is part of the Allegis Group.
Diversity and Inclusion:
TEKsystems is an equal opportunity employer and welcomes all applications without regard to race, gender, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information, or any characteristic protected by law.
