Authorization Coordinator

Franklin County Medical Center•Preston, ID

just now•Onsite

About The Position

Franklin County Medical Center (FCMC) is a non-profit critical access hospital with a vision to be the premier healthcare provider and facility of choice for the community. FCMC houses 20 beds in its acute care facility and 35 beds in its nursing facility, with three operating rooms, a procedure room, and advanced technology to provide excellent care for surgical patients. Their recently constructed 24,000 square foot medical office provides valuable access, accommodations, and services to the community. FCMC was recognized as one of the “Top 100 Critical Access Hospitals” in the nation for four consecutive years from 2017-2020 and aims to be in the top 20. As the largest employer in Franklin County, FCMC values its team members, including Authorization and Pre-Financial Coordinators, by offering competitive wages, flexible scheduling, encouraging a healthy work/life balance, and providing opportunities for education and growth through tuition assistance and promotions.

Requirements

High school diploma or GED
Computer literacy, including word processing, spreadsheet, and database management, and ability to use office equipment
Strong organizational and interpersonal skills and experience with customer service
Facilitation skills in order to support and work cooperatively with staff, patients, physicians, and external parties
Working knowledge of Medicare, Medicaid, HMO, and private insurance coverage criteria
Ability to act calmly and effectively in complicated or stressful situations
Ability to establish and maintain working relationships with manager and peers
Good communication skills, both written and oral, in the English language
Regular and predictable attendance is required
Regularly required to stand; walk; use hands to finger, handle, or feel; reach with hands and arms; requires eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, and other office equipment
Requires normal range of hearing and eyesight to record, prepare and communicate appropriate reports
Occasionally required to sit, climb, balance, and push or pull up to 30 pounds
Occasionally required to lift or carry up to 35 pounds
Must comply with HIPAA to protect information that is sensitive, proprietary, or confidential
Must wear Personal Protective Equipment (PPE) as situations require to maintain infection control standards set by the facility

Nice To Haves

Additional training or experience in the medical field preferred

Responsibilities

Execute the insurance authorization process, including verifying insurance eligibility, checking network status, learning benefit information, and obtaining prior authorization.
Serve as the liaison between insurance companies, patients/payers, and FCMC.
Assist patients with the hospital admission process.
Establish and maintain a detailed authorization tracking process.
Process requests that are approved, denied, or deferred, and resolve them promptly.
Answer and return phone calls from patients, physicians, and staff to respond to questions and requests.
Maintain appropriate turnaround time on authorization requests.
Input authorization information and documentation in appropriate software systems.
Notify financial counselors to calculate estimates for planned procedures based on estimated insurance allowable and patients benefits or cash pay rates.
Document all work and calls performed.