Care Coordinator, Authorization Scheduling Specialist - Atrium Health Poplar Tent

• Ensures information obtained is complete and accurate, applying acquired knowledge of Medicare, Medicaid, and third party payer requirements/on-line eligibility systems.

• Collaborates with internal departments to provide account status updates, coordinate the resolution of issues, and appeal denied authorizations.

• Collaborates with patient financial services to coordinate patient's financial resources and responsibilities including advanced beneficiary notice (ADN), as needed.

• Educates patients, staff and providers regarding authorization requirements, payer coverage, eligibility guidelines, documentation requirements, and insurance changes or trends.

• Maintains knowledge of and reference materials of Medicare, Medicaid and third-party payer requirements, guidelines and policies. Remains up-to-date on insurance plans requiring pre-authorization.

• Notifies patient accounts staff, scheduling and registration staff, and financial counselors of insurance coverage lapses and self-pay patient status.

• Educates staff on insurance changes, trends and prior authorization requirements.

• Maintains and updates files for insurance information and a list of current accepted insurance plans.

Licensure, Registration, and/or Certification Required:

• None Required.

Education Required:

• High School Graduate.

Experience Required:

• Typically requires 1 year of experience in customer service that includes experiences in patient accounts, third- party payer plans, accounts receivable/collection processes, and medical clinic processes and/or workflow.

Knowledge, Skills & Abilities Required:

• Knowledge of third-party payers and pre-authorization requirements.

• Understanding of basic human anatomy, medical terminology and procedures for application in the patient pre-certification / authorization processes.

• Intermediate computer skills including use of Microsoft Office (Excel and Word), electronic mail, physician practice management and electronic medical records systems.

• Strong analytical, prioritization and organizational skills.

• Ability to work independently with minimal supervision and to manage multiple priorities.

• Exceptional customer service and interpersonal skills.

• Must have the ability to effectively communicate with a variety of people under stressful circumstances.

Physical Requirements and Working Conditions:

• Exposed to a normal medical office environment.

• Sits the majority of the workday.

• Must be able to lift up to 10 lbs. occasionally.

• Operates all equipment necessary to perform the job.