Authorization Coordinator I
Company: Sentara Health
Location: Charlottesville
Posted on: April 17, 2024
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Job Description:
City/State
Charlottesville, VA
Overview
Work Shift
First (Days) (United States of America)
Sentara Martha Jefferson Hospital is hiring an Authorization
Coordinator - Full Time Day schedule
Martha Jefferson Hospital was founded in September 1903, by seven
local physicians. In July 1904, the new hospital opened its doors.
Since then, the hospital has focused on setting the standard for
clinical quality and personalized healthcare services. Located in
Charlottesville, Va., Martha Jefferson is a 176-bed facility
featuring all patient-friendly private rooms.
Benefits: Sentara offers an attractive array of full-time benefits
to include Medical, Dental, Vision, Paid Time Off, Sick, Tuition
Reimbursement, a 401k/403B, 401a, Performance Plus Bonus, Career
Advancement Opportunities, Work Perks and more.Our success is
supported by a family-friendly culture that encourages community
involvement and creates unlimited opportunities for development and
growth.
Be a part of an excellent healthcare organization that cares about
our People, Quality, Patient Safety, Service, and Integrity. Join a
team that has a mission to improve health every day and a vision to
be the healthcare choice of the communities that we serve!
Talroo - Allied Health, coordinator, insurance verification,
registration, billing
Job Summary
Responsible for review of the clinical information received from
physicians, department queues and other clinical providers,
ensuring clinical data is substantial enough to authorize services
for both 1 time visit account types and recurring accounts.
Analyzes clinical information to ensure the services requested are
authorized according to clinical and payer protocols. Responsible
for insurance verification, member benefits, obtaining
authorizations and pre-registration for the services requested.
Validates accuracy of insurance enrollment information in the
system prior to authorizing services, making certain policy is
active.
Requires knowledge of managed care contracting, clinical protocols
and clinical review requirements. Requires knowledge of regulatory
and compliance requirements, for both government and commercial
payers. Ensures appropriate and accurate information is entered
into systems for processing of patient care and reimbursement. Acts
as a liaison between patients, physicians, clinical department and
insurance companies.
Responsible to secure high volume less complex authorization work
as determined by payer behavior, time needed to authorize,
opportunity research and key performance indicators. Required to
have knowledge in modality and payer behavior. Accountable to
problem solve, investigate and help resolve problems for work
assignment. Must collaborate effectively with internal and external
teams to reach desired results as determined by key performance
indicators and leadership.
Medical Terminology and ICD-10 knowledge required.
Must be able to obtain and ensure timely authorizations, meeting
the needs of patient care. Ability to prioritize and expedite
authorizations with payer and/or medical management companies.
Recognizing priority for late notice patient testing. This position
works directly with clinical staff to schedule procedures, arrange
treatment plans, request peer to peer and obtain retro
authorizations. Also works with financial aid for patients without
coverage.
Qualifications:
HS - High School Grad or Equivalent (Required)
1 Year of Health Insurance Authorization, health insurance
verification, registration/billing., Health Insurance
Authorizations, Health Insurance Verification,
Registration/Billing
Skills
Communication, Microsoft Office, Service Orientation,
Technology/Computer, Time Management
Sentara Healthcare prides itself on the diversity and inclusiveness
of its close to an almost 30,000-member workforce. Diversity,
inclusion, and belonging is a guiding principle of the organization
to ensure its workforce reflects the communities it serves.
Per Clinical Laboratory Improvement Amendments (CLIA), some
clinical environments require proof of education; these regulations
are posted at ecfr.gov for further information. In an effort to
expedite this verification requirement, we encourage you to upload
your diploma or transcript at time of application.
In support of our mission to improve health every day, this is a
tobacco-free environment.
Keywords: Sentara Health, Charlottesville , Authorization Coordinator I, Other , Charlottesville, Virginia
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