The Centralized Authorization Coordinator is responsible for client/patient authorizations for a designated region within Home & Community Based Services.
- Oversees team obtaining authorization from payer’s case manager for services ordered/requested in a timely manner.
- Monitors documentation of specified details related to the authorization including effective and end dates using the appropriate software application, authorizations, tasks, patient notes, phone calls and/or email.
- Ensures additional pre-certification is obtained as needed and effective lines of communication are maintained between the agency and the payer.
- Performs quality reviews to ensure needed documentation detailed in agency system reflects documentation on notes.
- Coordinates and communicates with branch location regarding changes or update from the payer in a timely manner.
- Resolves all requests, inquiries, and concerns in an expedient and respectful manner.
- Problem solves independently before referring issues to the Supervisor for resolution.
- Assists in internal and external audits as required.
- Performs related duties as required or assigned.
- Any other duties as assigned.
Experience Requirements
- 3 to 5 years’ experience of healthcare experience.
- Accounts Receivable experience.
- Excellent oral and written communication skills.
- Excellent organizational and analytical skills.
- General knowledge of rules and regulations governing third party payers.
- Excellent interpersonal skills.
- Positive customer relations skills and the ability to work effectively as a member of interactive teams.
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