Insurance Authorization Coordinator

2 months ago

Stow, Ohio, United States Midwest Vision Partners Full time
Job Overview

As a key player in our organization, you will leverage your expertise in billing, clinical resources, and customer service to navigate the complexities of prior authorization processes. Your role is crucial in ensuring that our services are covered efficiently and effectively, contributing to the overall success of our Revenue Cycle.


Work Schedule

Monday - Friday, 8 am - 5 pm


Key Responsibilities

The following duties are essential to this position, but not exhaustive of all responsibilities that may be assigned.

  • Assess insurance requirements to establish if prior authorization is necessary.
  • Utilize various resources to identify any tests that may need prior authorization.
  • Examine patient documentation to confirm compliance with payer medical necessity guidelines.
  • Analyze requisitions to ascertain billing details, including insurance provider, and prepare accurate submissions as required.
  • Collaborate with clients to gather necessary medical documentation.
  • Complete and submit prior authorization requests to insurance providers through various channels, including phone, online platforms, or fax.
  • Conduct timely follow-ups with insurance companies regarding pending prior authorization requests.
  • Notify the appropriate Revenue Cycle Management department of the status of prior authorizations.
  • Maintain up-to-date knowledge of payer policies and requirements, serving as a resource for team members and patients.
  • Ensure compliance with HIPAA regulations.

Skills and Qualifications

What makes you an ideal candidate:

  • Proficient in reviewing patient charts to ensure accuracy and completeness.
  • Exceptional organizational skills with a keen attention to detail.
  • Able to work efficiently under pressure and manage high volumes of work.
  • Advanced understanding of medical billing and coding practices.
  • Consistently assist patients and physicians with inquiries related to insurance and authorization requirements.
  • Strong problem-solving abilities.

Required Knowledge:

  • Minimum of one year of experience in a clinical environment.
  • Familiarity with medical billing and coding.
  • High school diploma or equivalent.
  • Ability to work collaboratively as part of a team as well as independently.
  • Excellent interpersonal and communication skills.

Benefits
  • Competitive salary structure.
  • Comprehensive benefits package, including medical, dental, life, and disability insurance.
  • Generous paid time off program.
  • Company-paid holidays.
  • 401(k) retirement plan with employer matching.
  • A workplace culture centered on People, Passion, Purpose, and Progress.
  • Inspirational work environment.

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