Prior Authorization & Patient Care Coordinator

Overview

We are seeking a dedicated and detail-oriented Prior Authorization & Patient Care Coordinator to join our practice. This vital role involves managing insurance prior authorization processes, coordinating patient care, and ensuring seamless communication between patients, providers, and insurance companies. The ideal candidate will possess strong knowledge of health insurance policies, medical coding, medications, and electronic health records management, with a commitment to maintaining patient confidentiality and delivering exceptional customer service. This position offers an opportunity to contribute to improved patient outcomes through efficient authorization procedures and comprehensive care coordination.

Duties

• Obtain and process insurance prior authorizations by verifying coverage, submitting documentation, and following up with insurance providers to ensure timely approvals.
• Review medical records and documentation to support authorization requests, ensuring compliance with clinical confidentiality policies and HIPAA regulations.
• Utilize medical coding systems such as ICD-10, and ICD coding to accurately document procedures and diagnoses for billing and authorization purposes.
• Manage electronic health records (EHR) systems efficiently to track patient information, authorization statuses, and clinical notes.
• Communicate effectively with healthcare providers, patients, and insurance representatives to clarify requirements, answer inquiries, and resolve issues related to prior authorizations.
• Verify insurance coverage and benefits using health insurance policy knowledge to facilitate smooth patient care transitions.
• Maintain detailed records of all correspondence, authorizations, and medical documentation in accordance with regulatory standards.
• Support clinical staff by coordinating patient appointments, follow-up care, and ensuring adherence to managed care protocols.

Experience

• Prior experience working in a medical office setting or healthcare environment with familiarity in medical office procedures.
• Strong understanding of health insurance policies, managed care processes, and the requirements for insurance prior authorization.
• Proficiency in medical terminology ICD-10 and insurance verification processes.
• Experience using EMR/EHR systems for managing electronic health records efficiently.
• Knowledge of HIPAA regulations and clinical confidentiality policies to protect patient information at all times.
• Excellent customer service skills
• Familiarity with Microsoft Office and Excel applications for documentation, reporting, and correspondence purposes.

Join our team as a Prior Authorization & Patient Care Coordinator to play a crucial role in streamlining healthcare delivery while ensuring patients receive the appropriate care they need efficiently and confidentially.

Pay: $18.00 - $20.00 per hour

Expected hours: No more than 40.0 per week

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Work Location: In person

Salary : $18 - $20