Baptist
Department Case Management Administration
Job Description
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
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
2 years’ clerical/support experience in a medical environment
Education
High School Degree or equivalent
Training Special Skills
Solid intermediate computer skills, Microsoft Office Suite; Knowledge of medical terminology and insurance; Accurate data entry
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Responsibilities
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
2 years’ clerical/support experience in a medical environment
Education
High School Degree or equivalent
Training Special Skills
Solid intermediate computer skills, Microsoft Office Suite; Knowledge of medical terminology and insurance; Accurate data entry
#J-18808-Ljbffr