Authorization Coordinator

Adventist Health

1d

About The Position

Located in Templeton amongst the oak trees, Adventist Health Twin Cities has been serving northern San Luis Obispo County since 1977. Comprised of a 122-bed acute care facility, our team provides exceptional care in emergency medicine, orthopedics, obstetrics, digestive disorders, wound care, and various medical, surgical and outpatient services. Locals enjoy weekly farmers markets in downtown Templeton, farm-to-fork dining, beautiful landscapes for hiking and biking, and beach days just fifteen minutes away at Cambria and Morro Bay. Job Summary: Responsible for management of prior authorizations of all activities requiring referrals for procedures, serves as the key coordinator and liaison whose primary role is to expedite the collection process.

Requirements

• High School Education/GED or equivalent: Preferred
• Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.
• Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.

Nice To Haves

• Associate’s/Technical Degree or equivalent combination of education/related experience: Preferred

Responsibilities

• Performs daily reconciliation of scheduled procedures, documenting authorization numbers obtained by others, as well as obtaining any authorizations and retroactive authorizations as needed.
• Serves as the coordinator for scheduled and pre-authorized procedures.
• Reconciles, updates and obtains retroactive authorizations as needed.
• Performs insurance verification prior to office visit procedures.
• Interacts with providers and staff to provide guidance and advice with regard to billing, relative to necessary procedures.
• Serves as an authoritative source to reconcile and update the authorization numbers and generate a work list of authorizations needed.
• Communicates with insurance providers about the patient’s medical necessity, obtain authorization for needed authorizations and reconcile to the authorization database and/or hospital systems.
• Corrects inaccurate information, CPT and ICD9 codes that prohibit pre-authorization being secured and charges being entered into billing system.
• Performs other job-related duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees