Authorization Coordinator

4 weeks ago


Stamford, Connecticut, United States Stamford Health Full time
Job Summary

The Authorization Coordinator is responsible for ensuring that patients receive the necessary insurance pre-certification and pre-authorization for scheduled infusion center services or treatments. This role requires strong communication and organizational skills, as well as knowledge of 3rd-party insurance pre-certification and pre-authorization policies and procedures.

Key Responsibilities
  • Review referring physician orders and documentation to ensure medical necessity against specific insurance protocol requirements.
  • Proactively review infusion schedules and pre-register patients, obtain insurance verification and/or authorizations for scheduled and urgent infusion services.
  • Communicate with infusion center staff and pharmacy regarding individual patient plan payer requirements for drugs to be supplied by payer specialty pharmacy.
  • Actively communicate with infusion center and patient access staff regarding status of pending authorization for scheduled services.
  • Act as a direct liaison with referring provider's offices and patients regarding new, changed, or pending insurance authorizations.
  • Participate in development of on-going process improvements related to insurance verification, pre-registration, and authorization management processes.
Requirements
  • High School Graduate or equivalent.
  • At least 2 years medical coding and/or billing background.
  • Good PC skills, especially Microsoft Outlook, Word, and Excel.
  • Ability to effectively multi-task and learn/ adapt to new systems and technology.
Working Conditions

This is an on-site position, which allows for direct in-person communication with patients, staff, and providers. The nature of duties performed presents little or no potential for job-related injury.



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