Authorization Coordinator

Benefits

Kansas City Clinical Neurology 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 service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling
• Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing
• Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts

Note:

Eligibility for benefits may vary by location.

Seeking an Authorization Coordinator who is responsible for timely and accurate processes associated with pre-certification, obtaining and certifying authorizations, assisting with appeals of authorizations, and collaborating with the referral coordinator to ensure all approvals are obtained.

• Review and complete prior authorizations to ensure timeliness of appointments, testing, procedures, and claims filing.
• Obtain clinical information (including medical history, diagnosis, and relevant lab reports) necessary to complete the Prior Authorization to include insurance requirements.
• Follow criteria for all services requiring prior authorizations and submit requests in a timely manner. Ensure appropriate documentation is entered in the standard billing system.
• Track status of prior authorizations via payor authorization portals.
• Review denied claims for clinical accuracy and correct errors for claims resubmission.
• Support patient experience through patient-centered communications, demonstrating excellent customer service skills.
• Communicate with insurance companies for pre-certification/authorization/amendments.
• Recommend new approaches, policies, and procedures to influence continuous improvements in department efficiency and services performed.
• Actively participate in problem identification and coordinate resolution between appropriate parties.
• Use communication systems to facilitate communication with hospital partners.
• Ensure documentation is entered in standard format in billing system, including in applicable Health Information Systems and subsidiary systems if not automatically updated.
• Research patient visit history to ensure compliance with payor payment window rules; communicate patient payment responsibilities and guide them through necessary steps.
• Perform other related job functions as assigned.
• Adhere to Code of Conduct and Mission and Value Statements.

• High School Diploma or GED equivalent required

• One year of related experience with medical insurance plans and/or Medicare benefits verification required.
• One year medical clinic, urgent care, or hospital care setting experience preferred.
• Prior Authorization experience preferred.

Supporting HCA Healthcare's 186 hospitals and 2,400+ sites of care, Physician Services plays a crucial role as the main entry point for patients looking for high-quality healthcare within the HCA Healthcare system. With a focus on meeting the needs of our patients at all access points, Physician Services is dedicated to implementing innovative, physician-driven, value-added solutions to assist physicians in providing high-quality, patient-centered care, aligning with our mission to care for and enhance human life.

HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years,…