Medical Authorization Coordinator
2 weeks ago
At Ashe Memorial Hospital, we strive to provide exceptional patient-centered care, driven by our commitment to delivering high-quality health services.
Salary and Benefits
We offer a competitive salary of $55,000 - $65,000 per year, commensurate with experience, along with an excellent benefits package that includes medical, dental, and vision coverage.
Job Description
Job Summary: As a Medical Authorization Coordinator, you will be responsible for obtaining and validating prior authorization for scheduled services, communicating directly with patients and referring physicians, and ensuring timely resolution of authorization cases.
Key Responsibilities:
- Utilize work lists to contact utilization management companies or insurance payers to request authorization.
- Send timely requests to referring physicians for authorization numbers when necessary.
- Communicate authorization cases denied for medical necessity or requiring peer-to-peer review to the referring physician for resolution.
- Validate all authorizations for accuracy prior to exams.
- Follow up on pending authorizations with the appropriate entity and forward correspondence to offices for exams on their daily schedule.
- Document authorization in the scheduling system according to defined protocol.
- Answer incoming calls from offices, referring physicians, and patients regarding authorization requirements and status.
- Provide estimates of out-of-pocket costs after insurance processing prior to exams.
- Arrange dates and times based on patient needs and exam schedules.
- Reschedule exams if authorization is not obtained prior to appointment time.
- Execute eligibility searches using available applications.
- Research eligibility exceptions to locate missing information or determine absence of coverage.
Required Skills and Qualifications
To succeed in this role, you must have:
- A high school diploma or equivalent.
- One year of experience in the healthcare industry, preferably in obtaining insurance authorizations.
- No supervisory responsibilities or travel required.
Becoming Part of Our Team
We are committed to providing a dynamic and inclusive work environment where everyone feels valued and supported. We offer opportunities for growth and development, as well as a range of benefits to support your overall well-being.
Equal Employment Opportunity
Ashe Memorial Hospital is an equal opportunity employer and considers individuals for employment based on their abilities and performance. We strive to create a diverse and inclusive workplace where everyone can thrive.
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