Authorization Coordinator - Full Time, Days

Company: Adventist Health NW
Location: Simi Valley
Posted on: May 31, 2021

Job Description:

Adventist Health is more than an award-winning health system. We provide whole-person care to our communities and champion the greater good - from the operating room to the boardroom, we are driven by our unique passion to live God's love through health, wholeness and hope. From Oregon to Oahu, we have a calling to always do more. Now is your chance to apply your passion to our mission.

We're looking for someone to join our team as an Authorization Coordinator who:

Responsible for management of prior authorizations of all activities requiring referrals for procedures, serves as the key coordinator and liaison whose primary role is to expedite the collection process.

Essential Functions:

• Performs daily reconciliation of scheduled procedures, documenting authorization numbers obtained by others, as well as obtaining any authorizations and retroactive authorizations as needed. Serves as the coordinator for scheduled and pre-authorized procedures.
• Reconciles, updates and obtains retroactive authorizations as needed. Performs insurance verification prior to office visit procedures. Interacts with providers and staff to provide guidance and advice with regard to billing, relative to necessary procedures.
• Serves as an authoritative source to reconcile and update the authorization numbers and generate a work list of authorizations needed. Communicates with insurance providers about the patient's medical necessity, obtain authorization for needed authorizations and reconcile to the authorization database and/or hospital systems.
• Corrects inaccurate information, CPT and ICD9 codes that prohibit pre-authorization being secured and charges being entered into billing system.
• Performs other job-related duties as assigned.

You'll be successful with the following qualifications:

Education:

• High School Education/GED or equivalent: Preferred
• Associate's / Technical Degree or equivalent combination of education/related experience: Preferred

Work Experience:

• Knowledge of ICD-9 and CPT codes for the purpose of authorizations. Experience with government and non-government payers.

Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations, including, but not limited to, measles, mumps, flu (based on the seasonal availability of the flu vaccine typically during October-March each year), etc., as a condition of employment, and annually thereafter. Medical and religious exemptions may apply.

Keywords: Adventist Health NW, Simi Valley , Authorization Coordinator - Full Time, Days, Other , Simi Valley, California