Coordinator-Authorization

Department Case Management Administration Job Description

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.

• 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

• 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