Authorization Coordinator - TEKsystems : Job Details

Authorization Coordinator

TEKsystems

Job Location : San Carlos,CA, USA

Posted on : 2024-09-27T05:13:11Z

Job Description :

100% REMOTE BUT MUST LIVE WITHIN 50 MILE RADIUS OF THESE LOCATIONS:Have you got the right qualifications and skills for this job Find out below, and hit apply to be considered.* San Jose* East Bay* San Francisco* Sacramento* Modesto/Turlock

Description:The authorization coordinator position is responsible for performing the appropriate processes to verify patient eligibility, coordinate benefits, ensure insurance coverage, and determine if prior authorization is needed for said order. If needed, obtain authorization for tests, therapies, or referrals to specialists and document in the patient electronic medical record. This position will facilitate responses to patient and provider inquiries regarding authorizations and referrals within turnaround standards.

Additional Skills & Qualifications:

  • Referral Entry Functions
  • Monitor and resolve referral/authorization orders in the Referral Pool in Epic in a timely manner
  • Monitor daily urgent and pending referrals to ensure timeliness standards are met and customer service is maximized according to standard workflows
  • Ensure completeness and accuracy of referrals by confirming CPT, ICD, and/or HCPCS codes, requested provider, and/or place of service
  • Verify insurance is accepted by the Foundation for all incoming referrals
  • Obtain added medical information from providers and/or office staff as necessary for incoming referrals
  • Process referrals per standard work
  • Process referrals per health plan contracts and requirements
  • Provide necessary medical information to obtain final determinations when required
  • Research all no authorization denials and submit for retro authorizations
  • Obtain appropriate approval for requested orders
  • Maintain accuracy with attention to detail in each referral
  • Proactively researches problem issues related to own work and recommends resolutions

    • About TEKsystems:We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe, and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

    The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

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