Authorization Coordinator in Santa Fe Springs, CA at Avanti Hospitals

Date Posted: 6/13/2018

Job Snapshot

Job Description

Central Business Office

Job Title: Authorization Coordinator 

City: Santa Fe Springs / State: California    

Central Business Office

Day Shift

From 8:00 AM

To 4:30 PM

                                      


Job Description and Job Responsibilites

Job Title:  Authorization Coordinator

Job Summary: 

Responsible for obtaining authorizations pre- and post-billing for in-house and discharged patients for all financial classes. Works directly with Case Management/IPA’s/ Medical Groups and Health plans. Communicates with internal and external departments and works accounts on the CRC reports. Required to review clinical systems and document accounts on the hospitals financial systems accurately and timely. This positon will report to the Managed Care Manager and or CBO Director


Essential Job Duties: 

  • Obtain authorization pre & post billing
  • Review and work in-house patients off the census report
  • Fax information to health plans, IPA’s & medical groups as needed to obtain authorizations
  • Communicate directly with case management on problem accounts
  • Learn and utilize financial, imaging and clinical systems pertaining to job
  • Work accounts that fall on the CRC report up to 8 days after discharge
  • Enter in authorization numbers on hospital financial system so bills can drop
  • Scan hard copy authorization into imaging system
  • Document financial system appropriately and timely
  • Knowledge of Microsoft Excel to create spreadsheets on pending authorizations
  • Reviews and updates accounts with correct payor codes and addresses
  • Communicates with CBO nurses on retro appeals
  • Tag accounts appropriately on authorizations denied appearing on CBO worklist
  • Knowledge of hospital contracts and terms for authorization request
  • Assist in the TAR submission process for Medi-Cal patients as required
  • Notifies supervisor of any issues or problems
  • All other duties and projects as assigned

 Behavioral Standards: 

  • Exhibits customer and service oriented behaviors in every day work interactions.
  • Demonstrates a courteous and respectful attitude to internal workforce and external customers.
  • Communicates accurately and appropriately.
  • Works well and efficiently under minimal supervision.
  • Handles difficult situations in a discreet and professional manner.
  • Demonstrates a willingness to act as a representative of the hospital.
  • Maintains a good attendance record.
  • Adheres to timekeeping procedures at all times.
  • Is adaptable to changes in assignments and priorities.


Communication/Knowledge:

  • Provides accurate and timely written and verbal communication of information in a manner that is understood by all.
  • Able to listen, understand, problem-solve, and carry-out duties to ensure the optimal outcome.
  • Able to use IT systems in an accurate and proficient manner.

Collaboration/Teamwork:

  • Contributes toward effective, positive working relationships with internal and external colleagues.
  • Demonstrates cooperation, flexibility, reliability, and dependability in all daily work activities and a willingness to collaborate with others for the good of the customer and the organization.




Job Requirements

Education/Experience:

  • High school graduate or equivalent required
  • Prefer at least 2 to 3 years of current experience in an acute care hospital setting (Revenue Cycle Knowledge preferred)
  • Excel knowledge
  • Must be able to multi-task and work in a fast past environment

Licensure/Certifications:

  • N/A

ADA/Physical Demands:

  • To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required.  Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Such accommodations must be requested by the employee/applicant in order to be considered.
  • Required to stand; walk; sit; use hands to fingers, handle, or feel; reach with hands and arms; stoop, kneel, crouch, or crawl; talk and hear; and may taste and smell. The employee is regularly required to lift, push and/or pull weights in excess of 10 pounds, with assistance. Visual abilities, auditory abilities, must be intact to perform duties.

 

Job Requirements

Education/Experience:

  • High school graduate or equivalent required
  • Prefer at least 2 to 3 years of current experience in an acute care hospital setting (Revenue Cycle Knowledge preferred)
  • Excel knowledge
  • Must be able to multi-task and work in a fast past environment

Licensure/Certifications:

  • N/A

ADA/Physical Demands:

  • To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required.  Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Such accommodations must be requested by the employee/applicant in order to be considered.
  • Required to stand; walk; sit; use hands to fingers, handle, or feel; reach with hands and arms; stoop, kneel, crouch, or crawl; talk and hear; and may taste and smell. The employee is regularly required to lift, push and/or pull weights in excess of 10 pounds, with assistance. Visual abilities, auditory abilities, must be intact to perform duties.

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