Eligibility & Authorization Coordinator

Cure 4 The Kids Foundation • Las Vegas, NV

37d

About The Position

We are looking for the brightest and the best to join our team!

Are you under challenged in your current position? Are you looking for a career in a high paced complex clinical environment?

Two major benefits offered by Cure 4 The Kids Foundation

One of the most competitive compensation and comprehensive benefit packages in the field of healthcare
A state-of-the-art clinical and administrative environment located at 215 and Town Center, Summerlin on the Roseman University Campus

Cure 4 The Kids Foundation was voted #10 on the list of the 50 Best Non-Profits to Work For in The U.S.

What it takes to be part of our team

Are you an exceptional Eligibility and Authorization Coordinator who absolutely thrives on being part of an accountable team? Can you dedicate yourself to being part of a team serving the needs of children and their families? Do you bring the highest standards of integrity and professionalism to your team? Do you thrive in an environment where you are valued and appreciated for who you are, how hard you work and for that something special you bring to the teams you choose to work with? Are you looking for an organization that offers competitive compensation and one of the broadest and most comprehensive benefit packages available in the field of healthcare?

This is a role that requires a multi-disciplinary team approach to solving problems and patient challenges. "That's not my job" or "someone else can do it" is not in our team vocabulary because we are here to be of support to each other. The primary goal is to bring the best patient care and experience for our area's children.

POSITION DESCRIPTION

The Eligibility and Authorization Coordinator verifies patient insurance eligibility and benefits, secures required prior authorizations and referrals for office visits, and performs insurance verification activities for all patients. The position ensures accurate insurance data is maintained to support compliant billing, accurate collection of copays and deductibles, reduce denials, and facilitate timely patient care. This is a non-exempt, hourly position.

Requirements

• High school diploma or GED
• Minimum of one (1) year of experience in insurance eligibility verification.
• Minimum of two (2) years of experience in tertiary patient care setting involving interactions with a variety of medical services, contact with patients and families, and interaction with physicians.
• Experienced with insurance benefits, eligibility, and authorization processes.
• Working knowledge of commercial, managed care, Medicaid, Medicare, and other insurance plan benefits and coverage.
• Working knowledge of coordination of benefits (COB) guidelines and payer requirements.
• Familiarity with CPT, ICD-10, and HCPCS coding as it relates to eligibility verification, authorizations, and covered services.
• Strong verbal and written communication skills, with the ability to communicate clearly and professionally with patients, parents/guardians, payers, and internal staff.

Nice To Haves

• Associate’s degree
• Previous experience in authorizations.
• LANGUAGE SKILLS: English. Spanish preferred.

Responsibilities

• Verifies insurance eligibility and benefits for all patients across multiple specialties, including EPO, HMO, PPO, and POS plans, as well as federal and state programs such as Medicare, Medicaid and Copay Assistance Programs.
• Initiates discussions and follows up with patients, parents, payers, and other medical offices to obtain up-to-date insurance information.
• Updates all applicable practice management systems to reflect patients’ current and expired insurance coverage. Obtains and documents office visit copays, co-insurance, and other key insurance benefit information such as out-of-network provider participation and benefit limitations.
• Identifies and obtains authorizations and referrals for office visits for existing patients covered under insurance plans that require them.
• Communicates changes in each patient’s eligibility and benefits to various internal departments in a timely and professional manner using approved communication methods.
• Processes coordination of benefits (COB) updates or changes following payer guidelines, including submitting coverage additions and terminations to Medicaid Third Party Liability (TPL).
• Educates other departments of key insurance changes and best practices across carriers.
• Participates in educational activities, team huddles, and meetings to improve revenue cycle efficiency and patient experience during insurance changes.
• Maintains open communication with Team Leads and Managers and escalates trends, and/or complex insurance issues appropriately.
• Performs other duties as assigned.

Benefits

• One of the most competitive compensation and comprehensive benefit packages in the field of healthcare
• A state-of-the-art clinical and administrative environment located at 215 and Town Center, Summerlin on the Roseman University Campus

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED