Authorization Coordinator
TEKsystems
100% REMOTE BUT MUST LIVE WITHIN 50 MILE RADIUS OF THESE LOCATIONS:
San Jose
East Bay
San Francisco
Sacramento
Modesto/Turlock
Description:
The authorization coordinator position is responsible for performing the appropriate processes to verify patient eligibility, coordinate benefits, ensure insurance coverage, and determine if prior authorization is needed for said order. If needed, obtain authorization for test, therapies or referral to specialist and document in the patient electronic medical record. This position will facilitate responses to patient and provider inquiries regarding authorizations and referrals within turnaround standards. The authorization coordinator position is responsible for performing the appropriate processes to verify patient eligibility, coordinate benefits, ensure insurance coverage, and determine if prior authorization is needed for said order. If needed, obtain authorization for test, therapies or referral to specialist and document in the patient electronic medical record. This position will facilitate responses to patient and provider inquiries regarding authorizations and referrals within turnaround standards.
Additional Skills & Qualifications:
Referral Entry Functions
Monitor and resolve referral/authorization orders in the Referral Pool in Epic in a timely manner
Monitor daily urgent and pending referrals to ensure timeliness standards are met and customer service is maximized according to standard workflows
Ensure completeness and accuracy of referrals by confirming CPT, ICD and/or HCPCS codes, requested provider, and/or place of service
Verify insurance is accepted by the Foundation for all incoming referrals
Obtain added medical information from providers and/or office staff as necessary for incoming referrals
Process referrals per standard work
Process referrals per health plan contracts and requirements
Provide necessary medical information to obtain final determinations when required
Research all no authorization denials and submit for retro authorizations
Obtain appropriate approval for requested orders
Maintain accuracy with attention to detail in each referral
Proactively researches problem issues related to own work, and recommends resolutions
#prioritywest
About TEKsystems:
Were partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. Thats the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.