Authorization Coordinator

• Receives requests for authorizations through the electronic health record (EHR) and/or via phone, fax, or in person and ensures that they are properly monitored in a timely manner
• Processes authorizations and submits medical records to insurance carriers to expedite prior authorization processes.
• Manage correspondence with insurance companies, healthcare providers, specialists, and patients as needed, including documenting in the EHR as required.
• Assist healthcare providers with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed.
• Review the accuracy and completeness of information requested and ensure that all supporting documents are present.
• Review denials and follow-up with healthcare providers to obtain medically necessary information to submit an appeal of the denial.
• Prioritize incoming authorization requests by level of urgency to the patient.
  
• Maintain positive communications between Campbell Clinic and outside facilities, providers, and insurance carriers.
  
• Develop and foster relationships with patients to ensure them of Campbell Clinic's commitment to continuity of care.
  
• Respond regularly and timely to voicemails/emails that pertain to patient authorizations and/or referrals from patients, healthcare providers, pharmacies, insurance companies, and any other outside facilities as required.
• Communicate with patients concerning updates on authorizations and referrals on a regular basis and in a timely manner.
• Coordinate with the referral coordinator to ensure all authorizations and referral requests are processed in a timely manner.

• Covers shifts for other support staff on an as needed basis including referral coordinator, patient care techs, and receptionist/operator.
• Other duties as assigned.

• Must possess good people skills and customer service skills
• Strong time management skills
• Very attentive to details. It takes time to understand the reasons for authorizations and referrals, type of authorizations and provider needed, and insurance requirements
• Strong command of the English language, both written and oral
• Exhibits high ethical and professional standards
• Appropriate understanding of computer hardware (i.e. PCs, tablets, laptops) and software (i.e. Microsoft Office, email, internet, HER)
• Ability to "multi-task" in a high demand daily schedule
• Medical terminology and knowledge of common medication names is beneficial and recommended

• High school graduate or equivalent, required
• Medical assistant certification or higher, required
• One (1) year primary care experience, preferred
• One (1) year medical authorization/referral experience, preferred

Contact Information