Authorization Representative, Lourdes Imaging Center

Our Lady of the Lake Regional Medical Center • Lafayette, LA

67d

About The Position

At FMOLHS, we offer you so much more than just a job in the healthcare industry. We offer career opportunities for people who have a calling to share their gifts and talents as part of our healing ministry. As a Catholic hospital, we are here to create a spirit of healing. We offer you something special - the chance to do God's work by helping to serve people in need throughout our community, every day. The Authorization Rep ensures patients have been cleared for Hospital services, specialty service and office visits. Resolves pre-certification, registration and case-related concerns and determination of patient financial obligation prior to a patient's service or visit. Works with insurance carriers, financial counselors, specialists and other ancillary staff. Also responsible for accurately validating patient information and ensuring the patient's experience is best in class. Relies on guidelines to accomplish tasks. Relies on experience and judgment to complete job. Works under general supervision.

Requirements

• 1 year experience in medical office or hospital setting
• High School or equivalent
• Basic clerical and computer skills

Responsibilities

• Gathers information from the chart and clinic personnel regarding insurance coverage and reason for the procedure.
• Relays authorization approval, peer to peer request or denial status to the clinic personnel and physician timely to facilitate patient care.
• Accurately and efficiently processes referrals to specialists, hospitals and diagnostic centers in accordance with physician orders.
• Coordinates the referrals with insurance providers to minimize financial liability to the patient.
• Obtains/scans outside clinic records after patient appointment with specialist to assure continuity of care.
• Utilizes available resources to determine if physician is participating with patients' insurance plan.
• Attends meetings as required and participates on committees as directed.
• Assures that authorizations are obtained prior to date of service for 99% of cases scheduled.
• Schedules are reviewed prior to date of service to assure that authorization numbers have been obtained for all procedures that require one.
• Scans authorization confirmation/denials into chart in a timely manner to facilitate claims processing.
• Responsible for the verification of insurance information and documenting the need for authorization in the computer system.
• Contacts insurance carriers to secure authorization information.
• Acts as a resource for the department personnel as it relates to the authorization process and documentation required for services.
• Performs other duties as assigned or requested.

What This Job Offers

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