Lead Authorizations Coordinator

Are you passionate about the patient experience? At HCA Healthcare, we are committed to caring for patients with purpose and integrity. We care like family! Jump-start your career as a(an) Lead Operations Coordinator today with St. David's South Austin Medical Center.

This position is responsible for collecting financial and insurance information from pre-transplant, post- transplant and managed care patients, verifying coverage, and obtaining required pre-certifications. Acts as a resource to the Medical Director and BMT transplant team, in addition to Admitting and System Finance offices of transplant facilities in the St. David’s South Austin Medical Center. Communicates with insurance case managers. Counsels patients on financial issues surrounding the transplant.

Works closely with Transplant Social Worker, Physician and Coordinators. Communicates patient financial status with transplant team and others involved in the transplant process. Participates in providing patient specific care standards as directed, and follows service excellence standards to ensure high levels of patient satisfaction. Assist in review of Global contract cases to ensure proper insurance filing and complete follow-up on claim status until claim has finalized.

• Develop and maintain processes and procedures related to transplant clearance to provide for maximum reimbursement. Act as being the financial liaison between the Transplant inpatient and outpatient clinic with the patient/family.
• Obtains appropriate information on patient’s healthcare coverage.
• Obtains relevant insurance from patient.
• Verifies patient and living donor benefits with patient’s insurance.
• Determines if pre-certification is required for evaluation, transplant admission and/or follow-up care.
• Verify pharmacy benefits, authorization requirements and obtain authorization as needed.
• Coding and identifying CPT, ICD9 and ICD
  10 for clinical team and insurance
• Obtains required pre-certification from insurance company.
• Communicates with insurance case manager regarding the pre-certification process.
• Sends required patient information to case management.
• Attend and report on financial/ insurance status as needed at Bone Marrow Transplant meetings.
• Maintains appropriate communication with case management throughout the transplant process, to include pre and post treatment.
• Obtains necessary pre-certifications for post-transplant care.
• At the time of admission, informs business office and other involved providers of patient insurance coverage and pre-certification information.
• Compiling insurance designated required documentation and submits for review to insurance.
• Communicates financial concerns to other individuals involved with the patient.
• Keeps transplant team informed of patient’s financial situation and status within

Job Qualifications

• Preferred:
  Experience with patient registration, financial counseling or

• High school diploma or equivalent; strong interpersonal and organizational skills required; intermediate computer skills including Excel, Word, Outlook and various insurance verification databases.

St. David's South Austin Medical Center, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

• Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services
• Wellbeing support, including free counseling and referral services
• Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence
• Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of…