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Authorization Coordinator

2 months ago

Norfolk, Virginia, United States TEKsystems Full time
Position Overview

As a Authorization Coordinator

Explore your potential in a rewarding role:

What you can expect...

Career Advancement – Numerous opportunities for professional growth

Work Schedule – Fully in-office position. Monday to Friday (8:30 AM - 5:00 PM)

Attractive Compensation - Starting at $21.00+ per hour

Streamlined Interview Process – Access to additional resume support and pre-interview resources

Key Responsibilities...

  • Evaluate, process, and verify the medical necessity for each patient’s treatment and ensure documentation aligns with established pathways
  • Engage with nursing and medical personnel to communicate any limitations or specific requirements dictated by insurance policies
  • Provide timely feedback to physicians and management regarding documentation discrepancies and payer issues related to non-covered medications
  • Update coding and payer guidelines for clinical teams
  • Monitor treatment pathways and perform various administrative functions as required, including obtaining insurance authorizations and pre-certifications for services
  • Investigate alternative resources for non-covered services to mitigate payment denials
  • Each Clinical Insurance Reviewer operates from a designated queue within their EMR system.
  • They prioritize authorizations based on due dates or start dates provided by the healthcare provider.
  • They address their work queue first before proceeding with new authorizations.
  • They must respond promptly to clinics, as messages are sent through the EMR, ensuring timely communication since treatment cannot proceed without approval.
  • Utilize insurance carrier portals, navigate treatment pathways, and communicate with insurance companies to secure authorizations for chemotherapy IV and injectable medications.
  • Document authorization details within their EMR system, InoMed (G2), and their practice management software, Athena.

Essential Skills and Qualifications:

Insurance Authorizations | Insurance Verifications | Health Insurance Knowledge | ICD-10 Coding | CPT Coding | Medical Billing Expertise

Required Experience:

  • Minimum of 1 year in prior authorization roles
  • Familiarity with insurance payers
  • Knowledge of payer websites
  • Experience in Medical Billing or Accounts Receivable (as an alternative to authorization experience)
  • Proficiency in Insurance Verifications

About TEKsystems:

We are partners in transformation, assisting clients in activating ideas and solutions to leverage new opportunities. Our team of 80,000 collaborates with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe, and Asia. As a leader in Full-Stack Technology Services, Talent Services, and real-world applications, we work with forward-thinking leaders to drive meaningful change. This is the essence of true partnership. TEKsystems is a proud member of the Allegis Group.

We are an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information, or any characteristic protected by law.