Authorization Coordinator

Phoenix Heart PLLC•Glendale, AZ

About The Position

The Authorization Coordinator is a fast-paced role requiring exceptional attention to detail and a thorough understanding of insurance plans, networks, and authorization requirements. The coordinator secures prior authorization for diagnostic tests, verifies insurance eligibility and benefits, and checks certain medical necessity requirements before patient appointments. The role also supports clinic and billing personnel with referral and authorization information, maintains accurate patient records, and communicates with patients, referring physicians, primary care providers, health plans, and internal staff.

Requirements

At least 2 years of related experience and/or training.
In-depth knowledge and understanding of medical health insurance.
Diagnostic authorization testing experience.
Ability to handle stressful situations calmly and productively while maintaining a high degree of customer satisfaction.
Professional attitude.
Ability to solve problems, prioritize, and multitask in a deadline-driven environment.
Ability to make independent decisions regarding matters of significance.
Ability to work with little to no supervision.
Ability to work outside core business hours as needed.
Ability to work in a team environment and interact positively with team members.
Goal-oriented, with excellent time-management and organizational skills.
Excellent interpersonal skills and ability to interact effectively and work efficiently with people at all organizational levels, internally and externally.
Excellent verbal and written communication skills.
Keen attention to detail.
Ability to keep sensitive information confidential.
High proficiency with PC-based software programs.
High school diploma or equivalent.

Nice To Haves

Working knowledge of cardiology.

Responsibilities

Review the current appointment schedule, covering the current date through five days out, and the add-on schedule daily for authorizations and referrals needed.
Verify patient eligibility and benefits.
Contact referring physicians, primary care providers, or health plans to obtain paper referrals and authorizations.
Contact patients when proper insurance information is needed.
Handle calls from the check-in desk or patients regarding referral and authorization questions.
Update patient accounts with appropriate information.
Add referral and authorization information to specific dates of service before claim filing.
Assist billing personnel with questions regarding eligibility, authorizations, and referrals.
Review the EMR desktop, email, fax, and interoffice communications throughout the day, and respond within 24 hours of receipt.
Inform the manager of difficulties obtaining authorizations or referrals from insurance carriers or physician offices.
Inform the manager of changes made by insurance carriers or physician offices regarding authorization and referral processes.
Participate in referral and authorization education for clinic personnel as it relates to their positions.
Notify the Front Office Manager when Phoenix Heart has not received authorization or required referrals before a patient's visit.
Review the add-on schedule before leaving for the day to identify what is needed for the next day.
Scan referrals, authorizations, and other insurance-related paperwork into the patient's chart under the paperclip.
Provide concise and thorough documentation in patient charts.
Participate in new-hire and annual training as a condition of employment.
Perform other tasks as assigned.