Authorization Coordinator, Orthopaedic Practice

We are looking for an Authorization Coordinator to join the team in our Orthopaedic Practice.

The Authorization Coordinator is responsible for coordinating all hospital authorizations, notifications, and pre-certifications.

ESSENTIAL FUNCTIONS:

Coordinates all notifications, authorizations and reauthorizations for hospital inpatients and outpatients including series patients.

Participates in the patient care and claims process by ensuring that all notifications have been done, and authorizations have been received.

Communicates all insurance related information to Patient Access Representatives, and Business Office.

Reviews patient records when necessary to obtain relevant information for handling accounts.

Maintains an authorization log and a referral log and distributes the logs to appropriate departments.

Provides insurance information to patients.

Communicates with physician offices regarding preauthorization process.

Establishes and maintains effective communication between departments.

Posts charges after selecting and/or verifying CPT, ICD-9 and HCPCS codes for appropriateness.

Counsels patients on outstanding account balances, sets up payment plans and provides applications and assistance in completing the forms for those patients eligible for St. Vincent Regional Medical Center's financial assistance programs.

Collects and posts co-payments and checks patients in and out as needed.Job Requirements


MINIMUM QUALIFICATIONS:

High School Diploma required.

Ability to work collaboratively with physicians, hospital staff, the business office and payor sources.

Excellent communication (verbal, written, listening) and problem-solving skills.

Ability to appropriately confront issues.

Ability to manage multiple tasks and organize appropriately.

Ability to analyze and report data in a meaningful way.

Must be proficient in Microsoft Word and Excel.

Must possess a strong understanding of medical terminology, insurance verification, notification, and claims processes.

Must possess a strong understanding of CPT, ICD-9 and HCPCS codes

Five years’ experience in acute hospital setting with knowledge of clinical care and claims process.

Five years’ experience in obtaining authorizations and payor sources.