Prior Authorization Coordinator (Temporary) - Remote

Overview

The Prior Authorization Coordinator is responsible for verification of benefits and eligibility confirmation for patients, as well as obtaining all pre-authorizations and pre-certifications required for scheduled procedures as necessary and appropriate.

In Short

• Obtain pre-authorization for all procedures and treatments being provided prior to patient appointments.
• Verify patient insurance information is accurate and documented correctly.
• Investigate, report and analyze patient CPT codes not originally noted in the CPTN at the onset of the pre-authorization process.
• Review and resolve all reported authorization issues timely and effectively.
• Communicate authorization, and any financial and benefit coverage with patients and providers timely and professionally.
• Obtain appropriate documentation to validate the approval or denial of authorizations.
• Maintain patient file security and confidentiality by adhering to appropriate confidentiality and HIPPAA policies and guidelines.
• Advise management of identified trends with payers in an effort to minimize problems.
• Special projects as assigned.

Requirements

• High school diploma or equivalent
• Experience in a health care setting required
• ICD-10 and CPT knowledge required
• Proficiency in MS Office
• Comprehensive understanding of authorizations required
• Experience with EPIC gGastro preferred

Benefits

• Work with a national partner for successful regional gastroenterology practices.
• Maintain practice identities while thriving in a dynamic healthcare landscape.