Job Summary
The Authorization Coordinator is responsible for facilitating information documentation and transmission vital to the effectiveness of utilization review and supporting Baptist’s reimbursement strategy. Specifically the managed care techniques the Coordinator uses focuses on prior authorization for services using evidence based criteria. Areas of work include payer notification, authorization management, denial management, escalations, and communication and coordination between payer, business office and UR Team.
Responsibilities
- Completes payer notification
- Communicates incorrect payer with patient access
- Communicate with Utilization Review Nurse
- Works assigned queues in the electronic medical record
- Documents next review dates in the electronic medical record
- Documents and updates authorized or denied information on auth/cert screen in the electronic medical record
- Schedules peer to peer when indicated
- Completes assigned goals
Specifications
Experience
Minimum Required
- 2 years’ clerical/support experience in a medical environment
Preferred/Desired
- Previous authorization coordinator experience
Education
Minimum Required
- High School Degree or equivalent
Preferred/Desired
- Bachelor’s degree
Training
Minimum Required
Preferred/Desired
Special Skills
Minimum Required
- Solid intermediate computer skills, Microsoft Office Suite; Knowledge of medical terminology and insurance; Accurate data entry
Preferred/Desired
Licensure
Minimum Required
Preferred/Desired
Skills Required
- 2 years clerical/support experience in a medical environment
- High School Degree or equivalent
- Solid intermediate computer skills, Microsoft Office Suite
- Knowledge of medical terminology and insurance
- Accurate data entry
- Previous authorization coordinator experience
- Bachelor's degree
What We Do
Baptist Memorial Health Care is one of the country’s largest not-for-profit health care systems and the largest provider of Medicaid in the region. Baptist offers a full continuum of care to communities throughout the Mid-South and consistently ranks among the top integrated health care networks in the country. The health care system comprises 24 affiliate hospitals in West Tennessee, Mississippi and East Arkansas; more than 5,400 affiliated physicians; Baptist Medical Group, a multispecialty physician group with more than 900 providers; home, hospice and psychiatric care; minor medical centers and clinics; a network of surgery, rehabilitation and other outpatient centers; and an education system highlighted by Baptist Health Sciences University (formerly Baptist College of Health Sciences). Baptist employs more than 21,000 people, and in fiscal year 2022 contributed more than $455 million in community benefit and uncompensated care to the communities it serves. For more information, please visit www.baptistonline.org or follow us on Facebook or Instagram.
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