Authorization and Insurance Coordinator II - Days

Full time (40 hours weekly)
M-F 7:30am-4pm

General Summary

Performs a variety of support functions for each assigned facility including, but not limited to, monitoring imaging and infusion schedules to ensure authorizations have been obtained and answering calls regarding referrals and authorizations; or, insurance verification, obtaining authorizations, mailing patient responsibility letters, and receiving payments through the mail. Possesses a working knowledge of insurance requirements and restrictions.

Duties and Responsibilities

Essential Functions:

• Performs online and telephone authorization verification for outpatient imaging procedures and infusion procedures.
• Contacts provider offices to obtain authorizations and referrals as needed.
• Obtains authorizations for outpatient imaging procedures ordered by the facility providers as needed.
• Maintains appropriate documentation in Eclipsys and on the authorization spreadsheets.
• Notifies imaging sites of financial waivers or ABN's that must be signed at least two hours prior to testing or infusion.
• Contacts patients the evening prior to their procedure if authorization is not obtained to give them the option of rescheduling their study or signing a financial waiver.
• Answers phone calls regarding authorizations or referrals.
• Completes audit slips for registration errors.
• Performs online and telephone authorization verification for surgical patients, patients considering pulmonary rehabilitation, and patients undergoing other medical procedures.
• Sends patient letters documenting co-pay and deductible information.
• Obtains authorizations for outpatient surgeries and invasive outpatient procedures that do not use the PHAS process.
• Maintains appropriate documentation in Eclipsys.
• Receives patient co-pay and deductible payments in the mail. Documents the payments in Eclipsys and prepares the deposit of these funds.
• Assists pre-registration staff with insurance questions as needed.

Common Expectations:

• Ensures patient confidentiality.
• Maintains established policies and procedures, objectives, quality assessment and safety standards.
• Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation.
• Completes monthly statistical reports for Supervisor(s).
• Participates in department projects as assigned; makes proactive recommendations in updating department resources and reference materials.
• Trains new staff and provides on-going support and instruction when staff become independent in role. Conducts the department orientation process for new hires.
• Actively supports process flow improvement and provides constructive feedback to Supervisor.
• Resolves patient complaints in the absence of a supervisor.
• Serves as a resource and example to Level I staff by assisting with questions regarding registration, workflow, operations of the department and other miscellaneous inquiries. Consistently displays good judgment, decision making and independence in role, functioning with limited guidance and supervision.
• Achieves and maintains an applicable certification (Certified Healthcare Access Associate (CHAA) recommended)

Qualifications

Minimum Education:

• High School Diploma or GED Required

Work Experience:

• 1 year experience in current Access Operations Department Required

Courses and Training:

• Medical terminology within 180 days Required

Benefits Offered:

• Comprehensive health benefits
• Flexible spending and health savings accounts
• Retirement savings plan
• Paid time off (PTO)
• Short-term disability
• Education assistance
• Financial education and support, including DailyPay
• Wellness and Wellbeing programs
• Caregiver support via Wellthy
• Childcare referral service via Wellthy