Baptist Memorial Health Care
Coordinator-Authorization
Job Code: 22772
Job Family: CASE MGMT
Job Description Title: Coordinator-Authorization
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.
Job 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:
Reporting Relationships No
Work Environment Functional Demands: Sedentary Very light energy level Lift 10lbs. box overhead. Lift and carry 15lbs. Push/pull 20lbs. cart Light Moderate energy level Lift and carry 25-35lbs. Push/pull 50-100lbs. (ie. empty bed, stretcher) Medium High energy level Lift and carry 40-50lbs. Push/pull +/- 150-200lbs. (Patient on bed, stretcher) Lateral transfer 150-200lbs. (ie. Patient) Heavy Very high energy level Lift over 50lbs. Carry 80lbs. a distance of 30 feet. Push/pull > 200lbs. (ie. Patient on bed, stretcher). Lateral transfer or max assist sit to stand transfer.
Functional Demands Rating: Sedentary
Activity Level Throughout Workday: Physical Activity Requirements - Sitting Occasional Physical Activity Requirements - Standing Occasional Physical Activity Requirements - Walking Occasional Physical Activity Requirements - Climbing (e.g., stairs or ladders) Occasional Physical Activity Requirements - Carry objects Occasional Physical Activity Requirements - Push/Pull Occasional Physical Activity Requirements - Twisting Occasional Physical Activity Requirements - Bending Occasional Physical Activity Requirements - Reaching Forward Occasional Physical Activity Requirements - Reaching Overhead Occasional Physical Activity Requirements - Squat/Kneel/Crawl Occasional Physical Activity Requirements - Wrist position deviation Occasional Physical Activity Requirements - Pinching/fine motor activities Occasional Physical Activity Requirements - Keyboard use/repetitive motion Occasional Physical Activity Requirements - Taste Or Smell Physical Activity Requirements - Talk or hear Continuous
Sensory Requirements: Color Discrimination: Accurate Near Vision: Accurate Far Vision: Minimal Depth Perception: Minimal Hearing: Yes
Environmental Requirements: Blood-Borne Pathogens: Anticipated Chemical: Anticipated Airborne Communicable Diseases: Anticipated Extreme Temperatures: Anticipated Radiation: Anticipated Uneven Surfaces or Elevations: Anticipated Extreme Noise Levels: Anticipated Dust/Particular Matter: Anticipated
#J-18808-Ljbffr
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.
Job 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:
Reporting Relationships No
Work Environment Functional Demands: Sedentary Very light energy level Lift 10lbs. box overhead. Lift and carry 15lbs. Push/pull 20lbs. cart Light Moderate energy level Lift and carry 25-35lbs. Push/pull 50-100lbs. (ie. empty bed, stretcher) Medium High energy level Lift and carry 40-50lbs. Push/pull +/- 150-200lbs. (Patient on bed, stretcher) Lateral transfer 150-200lbs. (ie. Patient) Heavy Very high energy level Lift over 50lbs. Carry 80lbs. a distance of 30 feet. Push/pull > 200lbs. (ie. Patient on bed, stretcher). Lateral transfer or max assist sit to stand transfer.
Functional Demands Rating: Sedentary
Activity Level Throughout Workday: Physical Activity Requirements - Sitting Occasional Physical Activity Requirements - Standing Occasional Physical Activity Requirements - Walking Occasional Physical Activity Requirements - Climbing (e.g., stairs or ladders) Occasional Physical Activity Requirements - Carry objects Occasional Physical Activity Requirements - Push/Pull Occasional Physical Activity Requirements - Twisting Occasional Physical Activity Requirements - Bending Occasional Physical Activity Requirements - Reaching Forward Occasional Physical Activity Requirements - Reaching Overhead Occasional Physical Activity Requirements - Squat/Kneel/Crawl Occasional Physical Activity Requirements - Wrist position deviation Occasional Physical Activity Requirements - Pinching/fine motor activities Occasional Physical Activity Requirements - Keyboard use/repetitive motion Occasional Physical Activity Requirements - Taste Or Smell Physical Activity Requirements - Talk or hear Continuous
Sensory Requirements: Color Discrimination: Accurate Near Vision: Accurate Far Vision: Minimal Depth Perception: Minimal Hearing: Yes
Environmental Requirements: Blood-Borne Pathogens: Anticipated Chemical: Anticipated Airborne Communicable Diseases: Anticipated Extreme Temperatures: Anticipated Radiation: Anticipated Uneven Surfaces or Elevations: Anticipated Extreme Noise Levels: Anticipated Dust/Particular Matter: Anticipated
#J-18808-Ljbffr