AUTHORIZATION COORDINATOR

City/State

Virginia Beach, VA

Work Shift

First (Days)

Overview:

Sentara Health is hiring an Authorization Coordinator !

This is a full-time remote position available only to candidates residing in Virginia.

Responsible for review of the clinical information received from physicians, department queues and other clinical providers, ensuring clinical data is substantial enough to authorize services for both 1 time visit account types and recurring accounts. Analyzes clinical information to ensure the services requested are authorized according to clinical and payer protocols. Responsible for insurance verification, member benefits, obtaining authorizations and pre-registration for the services requested. Validates accuracy of insurance enrollment information in the system prior to authorizing services, making certain policy is active. Requires knowledge of managed care contracting, clinical protocols and clinical review requirements. Requires knowledge of regulatory and compliance requirements, for both government and commercial payers. Ensures appropriate and accurate information is entered into systems for processing of patient care and reimbursement. Acts as a liaison between patients, physicians, clinical department and insurance companies.

Education

• High School Grad or Equivalent required
• Related Associate level degree preferred

Certification/Licensure

• Licensed Practical Nurse (LPN) - Nursing License - Compact/Multi-State License – required

Experience

• 3 years - Related clinical experience as an LPN in acute Care, managed care or clinic setting.
• Familiar with NCQA standards and turnaround times for prior authorizations.
• Familiarity with MCG and InterQual clinical decision support tools for prior authorizations and utilization review

keywords:   registration, billing, authorizations, health insurance,

We provide market-competitive compensation packages, inclusive of base pay, incentives, benefits, and equity. The base pay rate for Full Time employment is:$22.36 - $37.26

Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.

In support of our mission “to improve health every day,” this is a tobacco-free environment.

For positions that are available as remote work, Sentara Health employs associates in the following states:

Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.