Authorization Coordinator

Comprehensive Community Health Centers Glendale, CA
JOB SUMMARY

Position is responsible for performing the appropriate processes to verify patient eligibility, coordinate benefits, ensure insurance coverage, and determine if prior authorization is needed for said order. If needed, obtain authorization for test, therapies or referral to specialist and document in the patient electronic medical record. This position will facilitate responses to patient inquiries regarding authorizations within specified time-frames

ESSENTIAL DUTIES AND RESPONSIBILITIES

* Obtain, review and request authorization and referrals as requested by the provider.

* Monitor and track patient authorizations.

* Document all communication in reference to the authorization from patients, insurances, and providers accordingly in a communication log in the patients electronic health record.

* Adhere to established criteria and timeframes for processing urgent/routine authorization requests.

* Researching and communicating with requesting provider for any identified amendments, such as codes and/or modified authorization requests.

* Verify and update necessary information in the patients medical record.

* Support excellent customer service philosophy.

* Providing effective departmental communication with both internal and external customers.

* Serves as communication liaison between internal departments, and patients.

* Demonstrate ability to communicate, problem solve, and work effectively with people.

* Ability to think analytically.

* Good communication and interpersonal/team skills.

* Must have a high regard for confidential information.

* Ability to work in a fast paced environment.

* Able to work independently and as part of a team.

* Stays in compliance with all HIPAA regulations.

* Encourage a cooperative, team approach to interdepartmental workflow

* Assist other departments as appropriate.

* Attend meetings as required.

* Performs other duties, as assigned.

EDUCATION, TRAINING AND EXPERIENCE

* High School Diploma or GED.

* Minimum of 3-5 years of experience in a medical office setting, or equivalent experience.

* Bilingual in Spanish or Armenian, preferred.

KNOWLEDGE, SKILLS AND ABILITIES

* Ability to find solutions when barriers are identified.

* Strong documentation skills.

* Ability to multi-task and prioritize when needed.

* Ability to independently seek out resources and work collaboratively.

* Ability to read, understand and follow oral and written instructions.

* Experience and work ethics that supports working within a high functioning, team-oriented environment.

* Demonstrates a willingness and ability to work under supervision.

* Ability to develop and maintain good working relationships with staff.

* Ability to use computer and learn new software programs.

* Excellent interpersonal skills reflecting clarity and diplomacy and the ability to communicate accurately and effectively with all levels of staff and management.

* Demonstrates ability to work in a regulatory climate that includes oversight of state and federal entities, payer contracts etc.

* Possesses ability to communicate effectively, both verbally and in writing.

* Possesses genuine respect for others and acceptance of their individual social and cultural traits.

* Proficient knowledge of Microsoft Outlook.

* Able to travel and attend professional meetings, conferences, trainings and clinic sites.

* Demonstrate flexibility, enthusiasm, and willingness to cooperate while working with others in multi-disciplinary teams.

* Performs other related duties as assigned.

PHYSICAL DEMANDS

Position requires prolonged sitting at a computer, some bending, lifting, stooping and stretching. Good eye-hand coordination and manual dexterity sufficient to operate a computer keyboard, photocopy machine, telephone, and other office equipment is also required. Employee must have normal range of hearing and eyesight.

NOTE: The essential job functions for this position include, but may not be limited to those listed in this job description. Employees hired for this position must be able to perform the essential functions of this job without imposing significant risk of substantial harm to the health or safety of themselves or others.

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