Authorization & Eligibility Coordinator – Healthcare/SaaS/EHR
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Job Description
Authorization & Eligibility Coordinator responsible for timely benefit verification and client credentialing for healthcare services. Position involves handling client enrollment and managing various health insurance payers.
Responsibilities:
- Ensure quality and timely benefit/eligibility verifications along with the management of client enrollment and credentialing for multi-specialty medical professional services
- Responsible for the verification and eligibility of patient health insurance benefits via external insurance web portals or over the phone
- Responsible for authorization submission as needed based on patient's health insurance requirements
- Assures all insurance information has been completely and accurately obtained
- Documents all pertinent insurance eligibility information
- Documents information given or received to support actions taken on insurance issues
- Assures all authorization information is documented completely and accurately for claims processing
- Review, evaluate and assist in creating processes and workflows for future benefit and authorization teams
- Monitor authorization exceptions to ensure timely claim billing
- Communicate with clients regarding authorization or eligibility issues or trends
- Assist external departmental personnel in strategically critical issues as the need arises
Requirements:
- High School Diploma, GED, or equivalent work experience
- Requires consistent judgment using software and industry expertise to analyze client needs and processes and then exercise discretion regarding how to configure and customize the solution
- Ability to teach end users in the solution's optimal use
- Requires knowledge of multiple medical specialties and the rules regarding their billing and documentation
- Understanding of accounting principles governing corporate reporting, teaching - including developing custom training plans and documentation
- Understanding of software engineering / development processes
- Well-developed verbal, listening and phone communication skills
- Good written communication skills with the ability to write routine correspondence
- Ability to add, subtract, multiply, and divide in all units of measure
- Ability to define problems, collect data, establish facts, and identify trends
- Strong organizational skills and ability to execute manual detailed tasks
- Strong customer service focus and commitment
- Ability to establish and maintain effective working relationships within the team
- Ability to work well with diverse personalities
- Tactful, mature and flexible
- Ability to work remotely
- Strong video conferencing etiquette
Benefits:
- Remote Work/Work From Home
- Paid Time Off/11 Paid Holidays/Year-End Holiday Break
- Health, Dental, Vision, HSA/FSA
- 401K with Company Match
- Disability & Life Insurance
- Employee Assistance Program
- Paid Parental Leave
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