Authorization Rep
APR Consulting, Inc. has been engaged to identify a Remote Authorization Coordinator
Location: Emeryville, CA 94608/ California in Greater Sacramento and/or Bay Area
Position: Remote Authorization Coordinator
Pay Rate: $24/hr
Duration: 26 weeks
Expected Shift: Day 5×8-Hour (09:00 – 17:00)
JOB SUMMARY
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, obtains authorization and documents in the patient electronic medical record. Facilitates responses to patient inquiries regarding authorizations within turnaround standards. “These Principal Accountabilities, Requirements and Qualifications are not exhaustive, but are merely the most descriptive of the current job. Management reserves the right to revise the job description or require that other tasks be performed when the circumstances of the job change (for example, emergencies, staff changes, workload, or technical development).
JOB ACCOUNTABILITIES:
- Verifies patient eligibility, facility approval, follows up as necessary to obtain authorization in a timely fashion and enters authorization numbers in medical record/computer as directed.
- Collects pertinent demographics and clinical data for each authorization required and places calls to insurance companies and/or reviews organizations to obtain authorization.
- Enters all authorization requests into the patient’s electronic health record utilizing appropriate codes, treatment types and providers.
- Communicates with physicians and department staff when there are issues with authorization.
- Interfaces with patients or third-party payers as necessary to gather additional information and convey approvals, denials or appeals.
- Provides excellent customer service by listening to provider, staff and patient concerns and assisting them in resolving issues in a courteous manner while documenting appropriately.
- Cross-trains others to assure consistent coverage; provide back up support as needed.
EDUCATION:
- Equivalent experience will be accepted in lieu of the required degree or diploma.
- HS Diploma or equivalent education/experience
TYPICAL EXPERIENCE:1 year recent relevant experience.
SKILLS AND KNOWLEDGE:
- Medical terminology, Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS)/International Classification of Diseases (ICD)-9 coding knowledge.
- Knowledge of medical terminology/anatomy.
- Ability to exercise discretion and make independent judgments, seeking review when decisions represent significant departure from established guidelines.
- Knowledge of Microsoft Office programs including Excel, Word or similar programs.
- Ability to maintain composure during challenging interpersonal interactions.
- Active listening skills; including interpersonal skills and telephone communication.
- Organizational skills with attention to detail and follow-up.
PHYSICAL ACTIVITIES AND REQUIREMENTS: See required physical demands, mental components, visual activities & working conditions at the following link: Job Requirements
NOTE: These statements describe the primary duties and responsibilities of the job and are not intended to be an exhaustive list of all tasks. Other work duties may be assigned at any time with or without notice.
Our client is the one of the largest Healthcare Staffing Provider in the United States, to be assigned at one of their affiliated hospitals/healthcare facilities.
This particular client is requiring that all new hires show proof of vaccination. However, accommodations may be made for those with disabilities or religious reasons who cannot obtain a vaccine.
Since 1980 APR Consulting, Inc. has provided professional recruiting and contingent workforce solutions to a diverse mix of clients, industries, and skill sets nationwide.
We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law. Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.
Don't miss out on this amazing opportunity! If you feel your experience is a match for this position please apply today and join our team. We look forward to working with you!
APR Consulting, Inc., is one of the most trusted talent acquisition and workforce solutions providers in the United States. Known for exceptional responsiveness, agile strategies, and consistently high-level talent, the firm has become a go-to for organizations and managed services providers navigating complex change and urgent challenges. Since its founding in 1980, APR has transformed from a California IT-focused staffing firm to a full-service solutions provider filling a wide range of positions and serving over eight industries — including aerospace and defense, healthcare, IT, telecom, hospitality/gaming, sports/entertainment, government, and utilities –– in all 50 states, with a loyal roster of more than 850 specialized professionals.