Alabama Heart and Vascular Medicine
Prior Authorization Coordinator
Alabama Heart and Vascular Medicine, New York, New York, United States,
We are seeking a self-motivated, detail-oriented Prior Authorization Coordinator. They will be responsible for obtaining pre-authorizations/pre-certification per payer requirements. Individuals will be responsible for contacting insurance companies, calculating estimated patient responsibilities, maintaining communication with providers, staff, and patients in relationship to authorization status. The ideal candidate will have a strong background in medical office procedures and insurance verification, ensuring timely approvals for medical office and hospital procedures.
Responsibilities:Verify patient eligibility and review benefitsVerify all codes are reviewable benefitsReview codes and submit prior authorization requestReview and submit clinicals documentationsFollow through with obtaining the prior authorizationCoordinate Peer-to-Peer review when neededSubmit AppealsCollect pre-payments when applicableSubmit retro-authorizations when applicableMeets department production standards consistently as defined by the department managementPerform all duties respectful of confidentiality and safety of all patients, employees, and providersRequires working knowledge of HIPAA Privacy Rules compliance
Minimum Qualifications:3 years of prior authorization experience5 years of insurance verification experienceExcellent verbal and written communication skillsExcellent interpersonal and customer service skillsExcellent organizational skills and attention to detailExcellent time management skills with a proven ability to meet deadlinesStrong analytical and problem-solving skillsAbility to prioritize tasksAbility to function well in a high-paced and at times stressful environmentGets along well with others and can work with peers in a team situation
Responsibilities:Verify patient eligibility and review benefitsVerify all codes are reviewable benefitsReview codes and submit prior authorization requestReview and submit clinicals documentationsFollow through with obtaining the prior authorizationCoordinate Peer-to-Peer review when neededSubmit AppealsCollect pre-payments when applicableSubmit retro-authorizations when applicableMeets department production standards consistently as defined by the department managementPerform all duties respectful of confidentiality and safety of all patients, employees, and providersRequires working knowledge of HIPAA Privacy Rules compliance
Minimum Qualifications:3 years of prior authorization experience5 years of insurance verification experienceExcellent verbal and written communication skillsExcellent interpersonal and customer service skillsExcellent organizational skills and attention to detailExcellent time management skills with a proven ability to meet deadlinesStrong analytical and problem-solving skillsAbility to prioritize tasksAbility to function well in a high-paced and at times stressful environmentGets along well with others and can work with peers in a team situation