Prior Authorization Coordinator

5 days ago


Providence, Rhode Island, United States CharterCARE Health Partners Full time
Job Summary:

The Prior Authorization Coordinator plays a vital role in facilitating patient and physician requests for diagnostic imaging and transfusion services within the Ancillary Support department at CharterCARE Health Partners.

Key Responsibilities:
  • Identify special needs, such as physical, language, or other barriers, and address them appropriately.
  • Obtain insurance/billing and hospital information, admitting services, and maintain ancillary support statistics according to protocol.
  • Effectively coordinate multiple appointments/procedures and referral requests with appropriate staff and resources while utilizing software.
  • Maintain relevant competent knowledge of healthcare insurances, prior authorization services, and ICD coding, consistently meeting established productivity requirements and maintaining a 96% or greater accuracy rate.
Requirements:
  • High School Diploma or equivalent required; College Degree or equivalent professional experience preferred.
  • Experience in a high-volume call center required; experience in a healthcare environment preferred; experience with obtaining diagnostic imaging prior authorization preferred.
  • Ability to work in a fast-paced environment while delivering excellent customer service required.
  • Effective communicator and ability to display professional demeanor under pressure required.
  • Strong computer skills in a Windows environment required.
  • Knowledge of medical terminology, healthcare insurances, and ancillary testing preferred.
Working Conditions:

General pleasant working environment with little or no distractions or exposure to unpleasant or hazardous elements.



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