Authorization Coordinator

1 week ago

Green Bay, Wisconsin, United States Caravel Autism Health Full time
Job Title: Authorization Coordinator

At Caravel Autism Health, we are seeking a highly skilled Authorization Coordinator to join our team. As an Authorization Coordinator, you will play a critical role in ensuring the timely and accurate coordination of client Third Party Payer verifications and authorizations.

Key Responsibilities:
  • Manage the authorization process, including timely receipt of authorizations from Third Party Payers.
  • Ensure authorization status is appropriately communicated to stakeholders.
  • Coordinate intake Third Party Payer information and enter it into the system.
  • Maintain practice management system(s) with authorized hours information.
  • Gather complete billing information for each client for all pay sources.
  • Create a system for billing requirements for each client and maintain this record system as it changes.
  • Communicate relevant billing information to Billing Specialists.
  • Verify benefits with insurance companies.
  • Update documentation on authorization policies and procedures and communicate to Billing Manager.
  • Understand principles of ICD-10 and CPT coding for initial evaluations, treatment plans, and ABA Therapy for authorizations to maximize revenue.
  • Answer and field billing and insurance questions with families.
  • Maintain billing information in the practice management systems.
  • Act as a resource for Billing Specialists for authorizations and insurance verification issues.
  • Review denials and implement timely appeal solutions as requested by Billing Specialists.
  • Provide oversight of medical records release requests, maintain patient charts for completeness and correct order, and keep authorizations for release of medical records current in the file.
  • Submit treatment plans as completed to appropriate Third Party Payers and maintain system to follow up on due dates of treatment plans.
Requirements:
  • High school diploma or equivalent, with coursework in medical insurance and/or billing preferred.
  • At least two years of previous medical insurance, billing, or claims processing related experience.
  • Experience working with the developmentally disabled or autistic spectrum clients is a plus.
  • Strong keyboarding and computer skills to include MS Office (Word and Excel) experience at an intermediate level.
  • Knowledge of medical billing and ICD-10, and CPT coding, as well as knowledge of financial concepts.
  • Knowledge of HIPPA privacy and security rules and regulations.
  • Excellent interpersonal skills, with the ability to communicate effectively with others.
  • Strong organizational skills, with the ability to multi-task and meet deadlines.
  • Demonstrates initiative, with the ability to manage self and workload.
  • Strong analytical and problem-solving abilities.
  • Exemplary customer service focus, for both internal and external clients.
  • Strong team player.
  • Displays professionalism and represents organization in a professional manner.
  • Ability to abide by ethical guidelines and policies, including strict adherence to confidentiality and HIPPA guidelines.

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