Prior Authorization Coordinator

Sturdy Memorial Hospital•Attleboro, MA

About The Position

The Prior Authorization Coordinator obtains authorization numbers from insurance companies for imaging exams and procedures when required. The role completes regular audits, resolves authorization issues, and works with multiple insurance carriers and vendors while staying current on changes affecting prior authorization. The coordinator communicates with relevant divisions in the ASG about approved or denied authorizations and works with Insurance Verification, the Central Billing Office, and other departments to resolve issues. The role manages the daily “Missing Prior Authorization” report from Insurance Verification and coordinates authorization processes using defined best practices, particularly internet applications.

Requirements

High school diploma.
2–3 years of medical secretarial or administrative support experience.
6–12 months of prior authorization experience.
Microsoft Office and internet skills.
Good customer service skills.
Ability to work in a team environment.
Ability to effectively communicate with all age levels served within the scope of the position and assigned areas.

Nice To Haves

Prior preauthorization experience.

Responsibilities

Obtain authorization numbers from insurance companies for imaging exams as required.
Obtain authorization numbers from insurance companies for imaging procedures as required.
Complete regular audits and resolve issues.
Work with multiple insurance carriers and vendors and stay current with changes related to prior authorization.
Communicate with specific divisions in the ASG regarding approved or denied prior authorizations.
Communicate with Insurance Verification, the Central Billing Office, and other departments to resolve prior authorization issues.
Manage the daily “Missing Prior Authorization” report received from Insurance Verification.
Coordinate authorization processes using defined best practices, specifically internet applications.