Authorization Coordinator II

Sentara
paid time off, tuition reimbursement, 401(k), 403(b)
United States, Virginia, Norfolk
Nov 22, 2024
City/State Norfolk, VA Overview Work Shift First (Days) (United States of America) Sentara Martha Jefferson Hospital is hiring an Authorization Coordinator II - Full Time Day schedule Required:HS Diploma or Equivalent Required:Health Insurance Authorizations, Health Insurance Verification or Registration/Billing experience - 2 years Medical terminology and ICD-10 knowledge required Sentara Health, an integrated, not-for-profit health care delivery system, celebrates more than 130 years in pursuit of its mission - "we improve health every day." Sentara is one of the largest health systems in the U.S. Mid-Atlantic and Southeast, and among the top 20 largest not-for-profit integrated health systems in the country, with 30,000 employees, 12 hospitals in Virginia and Northeastern North Carolina, and the Sentara Health Plans division which serves more than 1 million members in Virginia and Florida. Sentara is recognized nationally for clinical quality and safety, and is strategically focused on innovation and creating an extraordinary health care experience for our patients and members. Benefits: Sentara offers an attractive array of full-time benefits to include Medical, Dental, Vision, Paid Time Off, Sick, Tuition Reimbursement, a 401k/403B, 401a, Performance Plus Bonus, Career Advancement Opportunities, Work Perks and more.Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth. Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve! Talroo - Allied Health, coordinator, insurance verification, registration, billing Job Summary Responsible for reviewing clinical information obtained from physicians, department queues and other clinical providers, ensuring data is substantial enough to authorize services for appropriate visit account types. Analyzes clinical information to ensure the services requested are authorized according to clinical and payer protocols. Ability to properly obtain insurance eligibility, member benefits, obtain authorizations and complete pre-registration for the services requested. Validates accuracy of active insurance enrollment in the system prior to authorizing services. Responsible for assisting with covering work for other team members due to staff shortage, workload and or as deemed necessary my leadership. Responsible for assisting in managing team projects, collaborating with education and leadership on opportunity identification, resolutions, and implementation. Accurate assessment and review of patient treatment plans is required to include location and duration of care. Responsible for assisting with covering work for other team members due to staff shortage, workload and or as deemed necessary my leadership. Responsible for assisting in managing team projects, collaborating with education and leadership on opportunity identification, resolutions, and implementation. Must demonstrate the ability to be a critical thinker and the ability to collaborate positively with peers, leaders and department team members and leaders to fully support team and drive positive results demonstrated via key performance indicators. Required to stay up to date on payer authorization and benefit policies. Must demonstrate the ability to understand complex payer policy and treatment plans to secure authorization timely with correct documentational and with the appropriate payer requirements in a timely manner. Required to demonstrate excellent customer service skills with all customers to include patients, piers, department team members and leadership. Ability to act as a liaison between patients, physicians, clinical department, and insurance company. Medical terminology and ICD-10 knowledge required Responsible to secure semi complex, difficult authorization work as determined by payer behavior, time needed to authorize, opportunity research and key performance indicators. Required to have knowledge in modality and payer behavior. Accountable to problem solve, investigate and help resolve problems for work assignment. Must collaborate effectively with internal and external teams to reach desired results as determined by key performance indicators and leadership. Qualifications: HS - High School Grad or Equivalent (Required) Health Insurance Authorizations, Health Insurance Verification, Registration/Billing Skills Active Listening, Communication, Critical Thinking, Microsoft Office, Service Orientation, Social Perceptiveness, Speaking, Technology/Computer, Time Management, Troubleshooting Sentara Healthcare 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. Per Clinical Laboratory Improvement Amendments (CLIA), some clinical environments require proof of education; these regulations are posted at ecfr.gov for further information. In an effort to expedite this verification requirement, we encourage you to upload your diploma or transcript at time of application. In support of our mission "to improve health every day," this is a tobacco-free environment.