Medical Authorization Coordinator
hace 2 días
Medical Authorization Coordinator
We are seeking an experienced Medical Authorization Coordinator to join our team at RedValley. As a Medical Authorization Coordinator, you will be responsible for obtaining pre-certifications and pre-authorizations for procedures and medications, scheduling appointments for outpatient testing with other providers, transcribing and triaging patient calls to physicians, and coordinating patient appointments/orders.
Key Responsibilities:
- Review chart documentation to ensure the patient meets medical policy guidelines
- Prioritize incoming authorization requests according to the urgency
- Obtain authorization via the payer website or by phone and follow up regularly on pending cases
- Maintain individual payer files to include up-to-date requirements needed to successfully obtain authorizations
- Initiate appeals for denied authorizations
- Respond to clinic questions regarding payer medical policy guidelines
- Confirm the accuracy of CPT and ICD-10 diagnoses in the procedure order
- Contact patients to discuss authorization status
Requirements:
- Strong spoken and written English B2+
- 1+ Years of Experience in prior authorizations
- 3+ Years of Experience in the healthcare industry
- Experience with procedure authorizations in any medical field
- Basic typing and keyboarding skills
- Strong oral and written communication skills
- Highly detail-oriented
- Basic understanding of human anatomy, specifically musculoskeletal
- Proficient use of CPT and ICD-10 codes
We Offer:
- Opportunities to work in a fast-paced startup environment supportive of teamwork, ownership, and purpose
- Flexible working environment (flexible working hours, working from our state-of-the-art office space)
- One-of-a-kind company values and teamwork culture as well as a meaningful mission and challenging work
- Private health insurance for you plus a family member
- Great discount on lunch with our partnered restaurants
Job Type: Full-time
Application Question(s):
- Could you please rate your English proficiency on a scale of 1 to 10?
Experience:
- Prior Authorization: 1 year (Preferred)
- Healthcare: 2 years (Preferred)
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