Current jobs related to Pre-Service Authorization Coordinator - Smithfield, North Carolina - UNC Health Care

  • Clinical Services Coordinator

    2 weeks ago

    Smithfield, North Carolina, United States True Team Medical Full time

    Job SummaryWe are seeking a highly skilled and compassionate Clinical Services Coordinator to join our team at True Team Medical. As a key member of our ACT team, you will provide essential clinical services to our clients, ensuring their physical and mental well-being.Key Responsibilities:Monitor and coordinate medical services for clients, including...

  • Flight Operations Coordinator

    2 weeks ago

    Smithfield, North Carolina, United States Blue Line Aviation LLC Full time

    Job Title: SchedulerWe are seeking a highly organized and detail-oriented Scheduler to join our team at Blue Line Aviation LLC.Job SummaryThe Scheduler will be responsible for scheduling and maintaining checkride schedules for students, maintaining relationships with designated pilot examiners, coordinating their travel, verifying student information, and...

  • Fleet Maintenance Technician

    2 weeks ago

    Smithfield, North Carolina, United States Utilities Service Co Inc Full time

    Fleet Preventative Maintenance Technician Job DescriptionWe are seeking an experienced and skilled Fleet Preventative Maintenance Technician to join our team at Utilities Service Co Inc. In this role, you will be responsible for traveling with maintenance-related supplies to dispersed equipment and performing on-site maintenance activities on all machinery...

  • Financial Services Manager

    3 weeks ago

    Smithfield, North Carolina, United States Mills Auto Group Full time

    Financial Services Manager Job DescriptionMills Auto Group is seeking a highly skilled Financial Services Manager to join our team. As a key member of our sales team, you will be responsible for coordinating the sale of finance and insurance programs to customers.Key Responsibilities:Sell financing and insurance products and services to customersAttain goals...

  • Fire Training Coordinator

    1 month ago

    Smithfield, North Carolina, United States Johnston Community College Full time

    Job SummaryWe are seeking a highly motivated and experienced Fire Training Coordinator to join our team at Johnston Community College. The successful candidate will be responsible for planning, scheduling, and coordinating classes with fire departments, preparing lesson plans and tests for Fire and Rescue training, and performing other related duties as...

  • Pharmacist Coordinator

    3 weeks ago

    Smithfield, North Carolina, United States UNC Health Full time

    Job SummaryBecome part of a dynamic organization with a mission to improve the health and well-being of diverse communities. As a Pharmacist Coordinator, you will leverage your expertise to consult on clinical or operational practice areas and supervise a team or program in a pharmacy specialty area.Key ResponsibilitiesTeam Supervision: Oversee the...

  • Hospice Care Coordinator

    1 week ago

    Smithfield, North Carolina, United States Home Health & Hospice Full time

    Compassionate Care for a Fulfilling CareerAt 3HC Home Health and Hospice, we strive to provide high-quality, cost-effective care that surpasses industry standards. As a Hospice Nurse, RN, you will be responsible for coordinating all Hospice services in assigned counties, ensuring that our patients receive the best possible care.Key Responsibilities:Provide...

  • Pharmacist Coordinator

    1 week ago

    Smithfield, North Carolina, United States UNC Health Full time

    Job Summary:We are seeking a highly skilled Pharmacist Coordinator to join our team at UNC Health. As a key member of our pharmacy team, you will be responsible for supervising a team and/or program in a pharmacy specialty area, developing and reviewing clinical protocols and operational policies/procedures, and providing clinical and operational pharmacist...

  • Patient Access Coordinator

    1 week ago

    Smithfield, North Carolina, United States UNC Health Full time

    Job Summary: We are seeking a highly organized and detail-oriented Patient Access Coordinator to join our team at UNC Health. As a Patient Access Coordinator, you will play a critical role in ensuring that patient access processing is performed in accordance with procedure and documented in a timely and accurate manner in ADT and other clinical information...

  • Proposal Coordinator

    1 month ago

    Smithfield, North Carolina, United States S2Technologies Full time

    Job OpportunityS2Technologies is a dynamic and value-driven company committed to excellence and teamwork. We build relationships through trust and accountability and strive to exceed expectations. Our company culture emphasizes work-life balance and offers a supportive and flexible work environment.We are seeking an experienced and organized Proposal...

  • Social Services Professional

    6 days ago

    Smithfield, North Carolina, United States County of Johnston North Carolina Full time

    The County of Johnston North Carolina is seeking a skilled Social Services Professional to join its Child Health/CMARC program team.Duties and ResponsibilitiesCollaborate with healthcare professionals to provide comprehensive care to children and families.Develop and implement health education programs to promote healthy behaviors and outcomes.Conduct home...

  • Automotive Service Consultant

    2 weeks ago

    Smithfield, North Carolina, United States Classic Kia Smithfield Full time

    About the RoleWe are seeking a highly skilled Automotive Service Consultant to join our team at Classic Kia Smithfield. As an Automotive Service Consultant, you will be responsible for delivering exceptional customer service and ensuring the smooth operation of our service department.Key ResponsibilitiesAssist customers with scheduling appointments and...

  • Patient Care Coordinator

    2 weeks ago

    Smithfield, North Carolina, United States Liberty Health Full time

    Job SummaryWe are seeking an experienced Patient Care Coordinator to join our team at Liberty Health. As a Patient Care Coordinator, you will be responsible for providing care for assigned patients in collaboration with RN case managers and nurse practitioners.Key ResponsibilitiesObtain information for assigned patients based on the model of care...

  • Proposal Coordinator Specialist

    5 days ago

    Smithfield, North Carolina, United States S2Technologies Full time

    Job OverviewS2Technologies is a values-driven company that prioritizes excellence and teamwork. We foster relationships built on trust and accountability, striving to exceed expectations in all aspects of our work.We're seeking an experienced and organized Proposal Coordinator to join our corporate team from a remote work environment. Some travel will be...

  • Patient Care Coordinator

    2 weeks ago

    Smithfield, North Carolina, United States Liberty Health Full time

    Job SummaryWe are seeking an experienced Patient Care Coordinator to join our team at Liberty Health. The successful candidate will provide care for assigned patients in collaboration with RN case managers and nurse practitioners.Key ResponsibilitiesObtain information for assigned patients based on the model of care requirements.Communicate effectively with...

  • C-SNP Patient Care Coordinator

    5 hours ago

    Smithfield, North Carolina, United States Liberty Health Full time

    Liberty Health is seeking a dedicated and compassionate C-SNP Patient Care Coordinator to join our team.Job Summary:Collaborate with RN case managers and nurse practitioners to provide high-quality care for assigned patients.Conduct thorough assessments and evaluations to identify patient needs and develop effective care plans.Communicate effectively with...

  • RN Utilization Manager

    2 weeks ago

    Smithfield, North Carolina, United States UNC Health Full time

    Job SummaryUNC Health is seeking a skilled RN Utilization Manager to join our team. In this role, you will work collaboratively with patients, families, and interdisciplinary teams to ensure high-quality, efficient, and effective patient care.Key ResponsibilitiesConduct admission reviews and continued stay reviews to ensure appropriateness of patient care...

  • Intake Coordinator

    2 weeks ago

    Smithfield, North Carolina, United States UNC Health Full time

    Job SummaryBecome part of a dynamic organization with a mission to improve the health and well-being of diverse communities. This role is responsible for ensuring accurate and timely patient access processing in accordance with established procedures. The ideal candidate will possess excellent communication skills, attention to detail, and the ability to...

  • Intake Coordinator

    4 weeks ago

    Smithfield, North Carolina, United States UNC Health Care Full time

    Job SummaryWe are seeking a highly organized and detail-oriented Intake Specialist to join our team at UNC Health Care. In this role, you will be responsible for ensuring that patient access processing is performed in accordance with procedure and documented in a timely and accurate manner in ADT and other clinical information systems.Key...

  • Water Distribution Specialist

    3 weeks ago

    Smithfield, North Carolina, United States Government Jobs Full time

    Job Title: Water Distribution TechnicianGovernment Jobs is seeking a highly skilled Water Distribution Technician to join our team in Johnston County, North Carolina.About the Role:We are looking for a motivated and experienced individual to work in our Water Distribution Department. As a Water Distribution Technician, you will be responsible for maintaining...

Pre-Service Authorization Coordinator

2 months ago

Smithfield, North Carolina, United States UNC Health Care Full time
Job Overview:

Become an integral part of a diverse organization dedicated to enhancing the health and well-being of the communities we serve.

This role operates Monday through Friday from 8:00 AM to 5:00 PM.


Position Summary:

The Pre-Service Authorization Coordinator is responsible for securing approvals from all payors that necessitate pre-authorization or prior approval before or on the date of service. This role ensures that referrals are accurately created and associated with all relevant accounts.


Key Responsibilities:
  • Secure necessary approvals from all payors requiring pre-authorization or prior approval prior to or on the date of service.
  • Ensure that referrals are generated and linked to all pertinent accounts.
  • Gather required clinical and financial information for authorization when applicable.
  • Review accounts for medical necessity in accordance with NCCN, FDA, Medicare LCD/NCD coverage determinations, and payor guidelines.
  • Engage with revenue cycle coordinators or managers regarding accounts that do not meet medical necessity criteria.
  • Document all pre-authorizations and prior approvals in compliance with healthcare system standards.
  • Coordinate peer-to-peer or medical review cases with providers or clinic Patient Financial Counselors as necessary.
  • Conduct timely follow-ups on denials related to infusion and radiation therapy authorizations and medical necessity denials.
  • Maintain accurate documentation, follow-up, and appeals in line with payor guidelines, ensuring resolution of denied accounts.
  • Ensure that ADT information is current and precise to guarantee patient safety, billing accuracy, and coding integrity.

Education Requirements:
  • High school diploma or GED is required; an associate degree is preferred.

Licensure/Certification Requirements:
  • No specific licensure or certification is required.

Professional Experience Requirements:
  • A minimum of two years of experience in a healthcare environment, with exposure to patient registration, billing, denial management, or insurance authorization processes is required. Exceptional customer service, organizational skills, and basic computer proficiency are essential. Familiarity with medical terminology is desirable.

Knowledge, Skills, and Abilities:
  • Language Skills: Ability to read, analyze, and interpret complex documents. Capable of responding effectively to sensitive inquiries or complaints and crafting speeches and articles using innovative techniques.
  • Mathematical Skills: Proficiency in advanced mathematical principles and statistical theory.
  • Reasoning Ability: Ability to apply logical or scientific principles to a wide range of problems, dealing with nonverbal symbolism and various abstract and concrete variables.

Job Details:

This position is employed by UNC Health (Rex Healthcare, Inc., d/b/a UNC Health), a private, fully-owned subsidiary of UNC Health Care System.

Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

UNC Health is committed to providing reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as for those with disabilities.