Prior Authorization Coordinator

Midland Health • Midland, TX

4d

About The Position

The Prior Authorization Coordinator determines client benefits and obtains and tracks client authorizations for services. The role verifies patient eligibility, coordinates benefits, facilitates insurance coverage, and addresses patient concerns about authorizations and turnaround times. Success in this position requires attention to detail and the ability to work in a fast-paced environment.

The coordinator supports Revenue Cycle operations by communicating with insurers, providers, families, and colleagues; documenting authorization information; reviewing denials and submitting appeals when permitted by the payer; and coordinating surgery arrangements and related documentation.

Requirements

• Experience with electronic medical records (EMR) and medical terminology.
• At least 1 year of experience working with medical insurance and/or prior authorizations.
• Excellent verbal and written communication skills.
• Ability to work independently.
• Strong passion for serving clients.
• Strong decision-making and problem-solving skills.
• Ability to work under stress.
• Ability to perform the listed physical activities, including standing, walking, sitting, stooping, reaching, lifting, seeing, speaking, and hearing.

Responsibilities

• Contact insurance companies by phone or web to verify client medical benefits.
• Analyze reports, track authorizations, and obtain necessary authorizations for all services.
• Answer insurance coverage and prior authorization questions from providers, families, and other Revenue Cycle members.
• Use Microsoft Office and Electronic Health Records.
• Support Revenue Cycle operations and perform other duties as assigned.
• Verify benefits with insurance providers to ensure payment for services.
• Document prior authorization information in patient profiles, including approval dates, billing units, procedure codes, and authorization numbers.
• Review insurance denials and submit appeals when permitted by the payer.
• Schedule surgeries by coordinating with the surgical center, verifying times with patients, and preparing charts, pre-admission forms, and consent forms.

What This Job Offers

• Job Type: Full-time
• Education Level: No Education Listed