Job Summary

The Authorization Coordinator is responsible for facilitating information documentation and transmission vital to the effectiveness of utilization review and supporting Baptist’s reimbursement strategy. Specifically the managed care techniques the Coordinator uses focuses on prior authorization for services using evidence based criteria. Areas of work include payer notification, authorization management, denial management, escalations, and communication and coordination between payer, business office and UR Team.

Responsibilities

• Completes payer notification
• Communicates incorrect payer with patient access
• Communicate with Utilization Review Nurse
• Works assigned queues in the electronic medical record
• Documents next review dates in the electronic medical record
• Documents and updates authorized or denied information on auth/cert screen in the electronic medical record
• Schedules peer to peer when indicated
• Completes assigned goals

Specifications

Experience

Minimum Required

• 2 years’ clerical/support experience in a medical environment

Preferred/Desired

• Previous authorization coordinator experience

Education

Minimum Required

• High School Degree or equivalent

Preferred/Desired

• Bachelor’s degree

Training

Minimum Required

Preferred/Desired

Special Skills

Minimum Required

• Solid intermediate computer skills, Microsoft Office Suite; Knowledge of medical terminology and insurance; Accurate data entry

Preferred/Desired

Licensure

Minimum Required

Preferred/Desired