Authorization Management Coordinator
The Authorization Management Coordinator is responsible for providing program and initiative support across WellSky. This individual will be responsible for managing processes related to prior authorization requests. They will work closely with providers and payers, delivering outstanding communication and exceptional service.
Key Responsibilities:
- Serve as the primary point of contact for the health plan, providers, and client.
- Responsible for the intake, eligibility/notification, processing. triaging, case oversight, P2P Scheduling, denials and appeals processing and submission of a variety of authorization requests.
- Provide case review functions as assigned.
- Provide administrative support to the clinical review team as required to facilitate case resolution.
- Monitor turn around time on compliance reviews, authorizations, denials and appeals in real time to ensure 100% compliance with program performance metrics.
- Manage authorization requests and compliance review outcomes and facilitate various methods of communication with healthcare providers, payers and the client.
- Provide coordination and support for various programs and initiatives, including assisting with development and administration of programs.
- Maintain accurate documentation, collateral, and reporting to support program operations and goals.
- Troubleshoot and research best practices to provide process improvement and issue resolution.
- Communicate regularly with appropriate stakeholders to support timely completion of program deliverables.
- Perform other job duties as assigned.
Required Qualifications:
- Bachelor’s Degree or equivalent work experience preferred.
- At least 0-2 years of relevant work experience.
Preferred Qualifications:
- Experience in healthcare and/or a healthcare setting.
- Medical terminology proficiency preferred.
- Preference given to candidates with previous experience with automated hospital admission procedure systems, personal computers and customer service skills.
- Strong organizational management skills.
- Must possess excellent written and verbal communication skills.
- CNA, LPN, CA, PTA, OTA type certifications preferred.
Job Expectations:
- Willing to work additional or irregular hours as needed.
- Must work in accordance with applicable security policies and procedures to safeguard company and client information.
- Must be able to sit and view a computer screen for extended periods of time.
#LI-PG1
# Remote
WellSky is where independent thinking and collaboration come together to create an authentic culture. We thrive on innovation, inclusiveness, and cohesive perspectives. At WellSky you can make a difference.
WellSky provides equal employment opportunities to all people without regard to race, color, national origin, ancestry, citizenship, age, religion, gender, sex, sexual orientation, gender identity, gender expression, marital status, pregnancy, physical or mental disability, protected medical condition, genetic information, military service, veteran status, or any other status or characteristic protected by law. WellSky is proud to be a drug-free workplace.
Applicants for U.S.-based positions with WellSky must be legally authorized to work in the United States. Verification of employment eligibility will be required at the time of hire. Certain client-facing positions may be required to comply with applicable requirements, such as immunizations and occupational health mandates.
Here are some of the exciting benefits full-time teammates are eligible to receive at WellSky:
- Excellent medical, dental, and vision benefits
- Mental health benefits through TelaDoc
- Prescription drug coverage
- Generous paid time off, plus 13 paid holidays
- Paid parental leave
- 100% vested 401(K) retirement plans
- Educational assistance up to $2500 per year