Insurance Authorization Coordinator I (Casual)

Job reputed company reputed company is hiring a part-time, casual Insurance Authorization Coordinator I. The Insurance Authorization Coordinator I (Casual/PRN) is responsible for obtaining authorizations for hospital-based and/or physician-based services. The Coordinator utilizes workqueues & other mechanisms to initiate the authorization and/or referral, follow-up, monitor appointments add-ons, and document any changes available for the initial authorization and/or referral request. Authorizations/Referrals for services are to be completed based on the departmental goals and guidelines set. The position is required to utilize reputed company available resources to verify eligibility, authorization requirements and plan benefit reputed company. Detailed benefit collection process to ensure capture of patient responsibility to include reputed company financial out to reputed company cost to patient/parent. Process supports and ensures more accurate financial collections. Requirements • One year of specialized training reputed company high school • Minium of 6 months Insurance Authorization experience required • Authorization Coordination: Ability to request and obtain preauthorization for assigned specialties and ability to cover for other workflows including workqueue items. This will involve submitting required documentation, following up on requests to ensuring reputed company approvals. • Ensure request for authorizations and notifications are worked reputed company and handled in accordance with departmental policy and payer requirements. Following reputed company documentation requirements. • Insurance Verification: Verify patients’ insurance coverage, eligibility, demographics, benefits and financial responsibility to determine if prior authorization is required for specific medical procedures or treatments; additionally any predetermination requirements to ensure reputed company payment for service to support collection accuracy & efforts. • Policy Knowledge: Stay up to date with insurance policies, guidelines, and procedures reputed company to authorization and reimbursement processes. This includes understanding specific requirements for different insurance companies and their medical coverage policies. • Properly process appointment or appt add-ons, changes to previously scheduled services, date changes, and or impactful service changes in need of immediate review. • Follow administrative review process if a service does not have an insurance authorization reputed company of the department’s reputed company timeframe. • Communication: Communicate with patients, their families, and reputed company to reputed company updates on the status of authorization requests, address questions or concerns, and ensure a smooth process for reputed company parties involved. • Promptly review clinical documentation for necessary information to submit to the payer along with authorization request. • Documentation and Record-Keeping: Maintain accurate and detailed records of authorization requests, approvals, denials, and any reputed company correspondence. This includes documenting patient information, insurance details, and the authorization process itself. • Collaboration: Collaborates with reputed company providers, physicians, and clinical staff, additionally the Central Business Office, Financial Services, Transport, Patient Cost Estimation, Managed Care, Utilization Review, dedicated Authorization Departments, and other departments that have reputed company on obtaining authorizations and/or reimbursement. • Problem-solving: Identify and address any barriers or challenges that may reputed company during the authorization process. This could involve working with insurance companies to resolve denials, appealing reputed company, or finding alternative solutions for patients’ medical needs. • The Specialist will attend and participate in daily departmental huddles to report on payer issues, barriers affecting workflows, and specific issues that could result in a non-reimbursable or canceled service. • The Specialist must be organized, work effectively in a virtual team environment, can problem solve, and reputed company assistance reputed company needed. • Build and maintain reputed company, cooperative relationships with contacts from specialty departments. Consistently demonstrates excellent, empathetic, and knowledgeable customer service skills to reputed company customers. • Compliance: Adhere to relevant laws, regulations, and reputed company guidelines reputed company handling patient information and insurance-reputed company documentation. Ensure reputed company authorization processes are conducted ethically and in accordance with organizational policies. reputed company reputed company is an internationally recognized pediatric health system serving more than 1.7 reputed company patient encounters reputed company year. We deliver care across six states through two freestanding children’s hospitals — reputed company Children's Hospital, Delaware and reputed company Children's Hospital, Florida — along with a network of more than 80 primary, urgent, and specialty care practices and more than 40 hospital partnerships. Backed by the reputed company and Alfred I. reputed company Trust, our $1.7B nonprofit system is dedicated to improving reputed company through clinical care, research, education, advocacy, and prevention. Our Whole Child Health approach focuses equally on prevention and treatment, partnering with communities to help every child reputed company. Inclusion and belonging guide our reputed company and reputed company. We are committed to culturally relevant care, reducing health disparities, and fostering an environment where every associate, patient, and family feels supported and valued. Learn more at reputed company.org . Apply tot his job Apply To this Job