Authorization and Insurance Verification Coding Lead - Requisition #599081

About the position

Responsible for overseeing the Physician services verification and authorization process for the Organization. Provides accurate and timely insurance verification of eligibility and authorization. Audits clinical documentation to validate coding accuracy pre and post service.

Responsibilities

• Consistently uses an outward mindset and puts forth exemplary effort in accomplishing his/her goals and objectives in a manner that helps others to achieve their goals and objectives.
• Provides accurate and timely insurance verification and authorization for ancillary, surgical, inpatient, and physician services.
• Follows appropriate point of service collection and notification processes.
• Demonstrates accuracy in gathering information and inputting data in all phases of insurance verification and the authorization process.
• Communicates with physicians, physician offices and hospital staff to obtain clarifying documentation for correct coding validation.
• Appeals denied claims related to authorization process.
• Trains and mentor staff on insurance verification, authorization, coding validation processes and best practices.

Requirements

• 18 years of age.
• CCA or equivalent certification.
• Relevant clinical or medical experience related to healthcare insurance verification, authorization and/or coding.

Nice-to-haves

• Knowledge of clinical and medical terminology.
• Knowledge of ICD-10 and CPT coding.
• Strong leadership skills.
• Strong verbal communication skills.
• Strong interpersonal skills.
• Strong organizational skills.
• Strong customer service skills.
• Strong critical thinking skills.