Whitman Hospital and Medical Center
Authorization and Eligibility Coordinator
Whitman Hospital and Medical Center, Colfax, Washington, United States, 99111
Authorization And Eligibility Coordinator
It's fun to work in a team where people truly believe in what they are doing! Rewarding career. Competitive salary. Outstanding benefits. The Authorization and Eligibility Coordinator at Whitman Hospital and Medical Clinics is responsible for ensuring accurate and timely insurance validation, benefits verification, and prior authorization for scheduled services. This role supports financial clearance and front-end revenue cycle operations by reducing claim denials and improving the patient financial experience. This position requires expertise in payer guidelines, attention to detail, and strong communication skills. Standard Expectations
Promotes a Positive Working Environment
Conducts oneself in line with organization's mission, values, and standards of behavior. Accepts change and challenges with a positive attitude. Consistently adheres to organizational policy.
Communicates Effectively
Builds relationships and works collaboratively with other staff. Provides timely operational updates to supervisor. Responds to communications in a timely manner.
Performs Duties Efficiently and Effectively
Follows procedures. Acts in compliance with applicable federal, state, and local regulations. Performs other duties as assigned.
Duties & Responsibilities
Prior Authorization Respond promptly to urgent or same-day authorization requests to prevent care delays. Obtain prior authorizations for therapy, diagnostic procedures, surgeries, specialty services, and inpatient admissions in accordance with payer requirements. Gather and submit supporting clinical documentation through appropriate channels (portals, fax, or phone). Monitor authorization status and follow up to ensure approvals are received before the date of service. Record authorization numbers, expiration dates, and service-specific notes in the EMR. Communicate denials, delays, or additional documentation needs to clinical and administrative staff. Insurance Verification Verify active insurance coverage using payer portals, websites, or clearinghouse systems. Confirm policy details, including group and policy numbers, COB status, and plan effective dates. Resolve discrepancies related to coverage termination, COB conflicts, or subscriber errors. Document and update accurate eligibility information in the EMR system. Alert scheduling and registration teams to eligibility concerns promptly. Contact patients directly to obtain updated or missing insurance information as needed. Benefit Verification Review and confirm insurance benefits for scheduled services to assess coverage, exclusions, and limitations. Identify patient financial responsibility, including copays, coinsurance, and deductibles. Flag preauthorization and referral requirements, network status, and plan-specific restrictions. Communicate estimated out-of-pocket costs to patients prior to service. Work with financial counseling or billing staff to resolve complex benefit-related questions. Ensure benefit details are fully documented and accessible in the EMR. Collaboration & Communication Coordinate with registration, scheduling, billing, and clinical teams to ensure complete financial clearance prior to service. Serve as a subject matter expert on insurance verification and authorization processes within the Patient Financial Services team. Communicate clearly and respectfully with patients and insurance representatives. Contribute to team meetings, training, and performance improvement initiatives. Qualifications
Required High school diploma or equivalent. 1-3 years of experience in insurance eligibility, benefits verification, and prior authorization in a hospital or clinic setting. Experience working with commercial, Medicare, Medicaid, and managed care payers. Preferred Associate degree or healthcare-related certification. Proficiency with Epic EMR and payer portals. 35 years of experience in insurance eligibility, benefits verification, and prior authorization in a hospital or clinic setting. Work Environment and Physical Demands
This position is primarily worked in an office environment. Primarily stationary with occasional standing, walking, lifting, reaching, carrying, kneeling, bending, stooping, pushing and pulling of objects weighing up to 20lbs. The position requires continuous finger dexterity and fine manipulation. The employee must demonstrate the ability to perform the essential functions of the position, with or without reasonable accommodation. If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us! Pay Range: $21.00 - $36.75 Compensation: New hires should expect to start at the lower end of the range; actual pay offered will vary based on years of experience. Employee Benefits: Our benefit package includes medical, dental, vision, life insurance, and retirement options (403(b) & 457). Medical insurance coverage begins on day one and is available to both full time and part time employees. Additionally, employees receive discounts on medical services provided by Whitman Hospital and Medical Clinics. Differentials apply for evening, night, and weekend shifts. Our unique PTO plan enables employees to increase their accrual with each year of service (no more waiting five years for the next tier)!
It's fun to work in a team where people truly believe in what they are doing! Rewarding career. Competitive salary. Outstanding benefits. The Authorization and Eligibility Coordinator at Whitman Hospital and Medical Clinics is responsible for ensuring accurate and timely insurance validation, benefits verification, and prior authorization for scheduled services. This role supports financial clearance and front-end revenue cycle operations by reducing claim denials and improving the patient financial experience. This position requires expertise in payer guidelines, attention to detail, and strong communication skills. Standard Expectations
Promotes a Positive Working Environment
Conducts oneself in line with organization's mission, values, and standards of behavior. Accepts change and challenges with a positive attitude. Consistently adheres to organizational policy.
Communicates Effectively
Builds relationships and works collaboratively with other staff. Provides timely operational updates to supervisor. Responds to communications in a timely manner.
Performs Duties Efficiently and Effectively
Follows procedures. Acts in compliance with applicable federal, state, and local regulations. Performs other duties as assigned.
Duties & Responsibilities
Prior Authorization Respond promptly to urgent or same-day authorization requests to prevent care delays. Obtain prior authorizations for therapy, diagnostic procedures, surgeries, specialty services, and inpatient admissions in accordance with payer requirements. Gather and submit supporting clinical documentation through appropriate channels (portals, fax, or phone). Monitor authorization status and follow up to ensure approvals are received before the date of service. Record authorization numbers, expiration dates, and service-specific notes in the EMR. Communicate denials, delays, or additional documentation needs to clinical and administrative staff. Insurance Verification Verify active insurance coverage using payer portals, websites, or clearinghouse systems. Confirm policy details, including group and policy numbers, COB status, and plan effective dates. Resolve discrepancies related to coverage termination, COB conflicts, or subscriber errors. Document and update accurate eligibility information in the EMR system. Alert scheduling and registration teams to eligibility concerns promptly. Contact patients directly to obtain updated or missing insurance information as needed. Benefit Verification Review and confirm insurance benefits for scheduled services to assess coverage, exclusions, and limitations. Identify patient financial responsibility, including copays, coinsurance, and deductibles. Flag preauthorization and referral requirements, network status, and plan-specific restrictions. Communicate estimated out-of-pocket costs to patients prior to service. Work with financial counseling or billing staff to resolve complex benefit-related questions. Ensure benefit details are fully documented and accessible in the EMR. Collaboration & Communication Coordinate with registration, scheduling, billing, and clinical teams to ensure complete financial clearance prior to service. Serve as a subject matter expert on insurance verification and authorization processes within the Patient Financial Services team. Communicate clearly and respectfully with patients and insurance representatives. Contribute to team meetings, training, and performance improvement initiatives. Qualifications
Required High school diploma or equivalent. 1-3 years of experience in insurance eligibility, benefits verification, and prior authorization in a hospital or clinic setting. Experience working with commercial, Medicare, Medicaid, and managed care payers. Preferred Associate degree or healthcare-related certification. Proficiency with Epic EMR and payer portals. 35 years of experience in insurance eligibility, benefits verification, and prior authorization in a hospital or clinic setting. Work Environment and Physical Demands
This position is primarily worked in an office environment. Primarily stationary with occasional standing, walking, lifting, reaching, carrying, kneeling, bending, stooping, pushing and pulling of objects weighing up to 20lbs. The position requires continuous finger dexterity and fine manipulation. The employee must demonstrate the ability to perform the essential functions of the position, with or without reasonable accommodation. If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us! Pay Range: $21.00 - $36.75 Compensation: New hires should expect to start at the lower end of the range; actual pay offered will vary based on years of experience. Employee Benefits: Our benefit package includes medical, dental, vision, life insurance, and retirement options (403(b) & 457). Medical insurance coverage begins on day one and is available to both full time and part time employees. Additionally, employees receive discounts on medical services provided by Whitman Hospital and Medical Clinics. Differentials apply for evening, night, and weekend shifts. Our unique PTO plan enables employees to increase their accrual with each year of service (no more waiting five years for the next tier)!