Description

JOB TITLE: Authorization Coordinator

EMPLOYER: Twelfth One, LLC dba Aspen Infusion

DEPARTMENT: Billing

REPORTS TO: Financial Clearance Manager

PAY RANGE: $21 - $24 per hour based on experience

SUMMARY: Verify insurance eligibility and benefits and ensure all notifications and authorizations are completed within the required timeframes. Obtain appropriate referrals, complete appropriate payor forms related to notification, schedule upcoming requests, and communicate the verification and authorization directly to patients and providers.

DUTIES AND RESPONSIBILITIES:

• Report any misconduct, suspicious or unethical activities to the Compliance Officer.
• Coordinate with internal and external teams/customers to obtain all information or assistance needed to effectively process an authorization request.
• Responsible for tracking and follow-up on all appeal and authorization submissions in the manner and time frame required by department policy and/or the insurance payer
• Responsible for communicating denial receipt, appeal options, and ongoing appeal status to the customer, healthcare team, and/or supervisor, based on departmental policy and procedure
• Responsible for communicating approval and billing information to the Insurance Specialist and/or Appeals Specialist based on departmental policy and procedure
• Ensure tasks are performed accurately, efficiently, and timely to meet departmental and insurance payor guidelines.
• Handle incoming and outgoing calls from internal team members, insurance payers, and customers related to the authorization/appeal process
• Collaborate with external and internal team members and customers to create a remarkable experience for our customers, maximize reimbursement and business opportunities
• Cross-train within the department to ensure smooth workflow and functional coverage
• Report recurring payer issues, trends, or changes to the supervisor
• Participate in department meetings
• Attends HIPAA training and other training sessions as required
• Understand and comply with all applicable company policies and procedures
• Perform other related duties as directed by the supervisor

SUPERVISORY RESPONSIBILITIES:

• This job has no supervisory responsibilities.

Requirements

QUALIFICATIONS:

• High school diploma or general education degree (GED), or one to three months related experience and/or training, or equivalent combination of education and experience.
• Computer skills required: Google software (Docs; Drive; Sheets)

COMPETENCIES:

Attendance/Punctuality - Is consistently at work and on time; Ensures work responsibilities are covered when absent; Arrives at meetings and appointments on time.

Interpersonal Skills - Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things.

Oral Communication - Speaks clearly and persuasively in positive or negative situations; Listens and gets clarification; Responds well to questions; Demonstrates group presentation skills; Participates in meetings.

Quality - Demonstrates accuracy and thoroughness; Looks for ways to improve and promote quality; Applies feedback to improve performance; Monitors own work to ensure quality.

Teamwork - Balances team and individual responsibilities; Exhibits objectivity and openness to others' views; Gives and welcomes feedback; Contributes to building a positive team spirit; Puts success of team above own interests; Able to build morale and group commitments to goals and objectives; Supports everyone's efforts to succeed.

Written Communication - Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information.

PHYSICAL DEMANDS AND WORK ENVIRONMENT:

• Continually required to stand, walk, sit, talk, and hear
• Continually required to utilize hand and finger dexterity
• The employee must occasionally lift and/or move up to 30 pounds
• Specific vision abilities required by this job include: Close vision; Distance vision; Color vision; Peripheral vision; Depth perception and the ability to adjust focus

The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities, or physical requirements. Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.