Job Summary

The position requires a strong understanding of insurance requirements including, but not limited to government, commercial, and workers’ compensation payors. The Authorization Coordinator is responsible for ensuring that all payor requirements are met to secure payment and provides patient cost estimates for procedures.

Detailed Responsibilities

• Verifies Eligibility and Benefits – Coordinate with patient’s medical coverage to ensure coverage is active and obtain benefits associated with plan as it pertains to the practice; inputs all payor demographic data into EHR system
• Obtains Referrals and Authorizations – Submit necessary requests for referrals and authorizations for all medical services including office visits, procedures, and DME; follows up with payors to ensure each patient scheduled has all items required to secure reimbursement; communicates with surgery scheduling regarding status of requests
• Produces Cost Estimates – Based on benefits obtained, creates and distributes cost estimates for all scheduled procedures; assists with incoming cost inquiries.

Education and Experience/Technical Skills

• High school diploma or equivalent
• Minimum of three years of work experience in a medical office business setting
• Minimum of two years of experience with medical insurance
• Proficient in MS Word, Excel, PowerPoint and Outlook
• Must be organized and detail-oriented
• Must possess excellent written and verbal communication skills
• Must be able to multi-task in a fast-paced environment and meet deadlines
• Knowledge of insurance terminology and concepts related to medical billing