MLee Healthcare Staffing and Recruiting, Inc
Authorization Coordinator | Oncology Care Specialist
MLee Healthcare Staffing and Recruiting, Inc, Selma, Iowa, United States, 52588
We are seeking a dedicated Authorization Coordinator specializing in oncology care to join a healthcare team serving the Midwest region. This role focuses on verifying prior authorizations, ensuring all outpatient orders meet medical necessity requirements, and maintaining accurate authorization records within the electronic health record system.
Key Responsibilities
Verify if prior authorizations are required and confirm authorization numbers are documented correctly. Review all orders for completeness and accuracy, obtaining missing information as needed. Send verification requests for providers not currently in the system, confirming licensure, National Provider Identifier (NPI), and contact details. Run Medicare orders through compliance software to validate medical necessity and follow up with providers for additional documentation when necessary. Obtain and ensure prior authorizations are approved before scheduling tests. Communicate with patients regarding Advanced Beneficiary Notifications (ABN) when required. Monitor daily schedules to confirm all orders and authorizations are in place prior to patient appointments. Manage EPIC work queues and stay current with patient account policies to assist patients and staff effectively. Collaborate with healthcare providers and insurance companies to resolve authorization issues and maintain accurate records of requests and outcomes. Educate patients about coverage options and the prior authorization process. Adapt to a fast-paced, dynamic environment while prioritizing tasks and fostering a servant leadership approach. Maintain confidentiality and meet physical demands of the role with or without accommodations. Education and Certification
Graduate of an accredited nursing program with current licensure as a Licensed Practical Nurse (LPN) or Registered Nurse (RN) eligible to work in the region. Current AAPC or RHIT certification is required. Experience and Skills
Proven experience in healthcare settings, preferably in prior authorization or medical billing. Strong knowledge of ICD-10-CM, HCPCS, CPT-4 coding, medical terminology, anatomy, and physiology. Familiarity with insurance policies and prior authorization procedures. Excellent verbal and written communication skills for effective interaction with providers, patients, and insurance representatives. Ability to analyze information and make decisions based on policies and regulations. Completion or willingness to complete Mandatory Reporter training within six months of hire. Commitment to compliance programs and ongoing education as required.
Key Responsibilities
Verify if prior authorizations are required and confirm authorization numbers are documented correctly. Review all orders for completeness and accuracy, obtaining missing information as needed. Send verification requests for providers not currently in the system, confirming licensure, National Provider Identifier (NPI), and contact details. Run Medicare orders through compliance software to validate medical necessity and follow up with providers for additional documentation when necessary. Obtain and ensure prior authorizations are approved before scheduling tests. Communicate with patients regarding Advanced Beneficiary Notifications (ABN) when required. Monitor daily schedules to confirm all orders and authorizations are in place prior to patient appointments. Manage EPIC work queues and stay current with patient account policies to assist patients and staff effectively. Collaborate with healthcare providers and insurance companies to resolve authorization issues and maintain accurate records of requests and outcomes. Educate patients about coverage options and the prior authorization process. Adapt to a fast-paced, dynamic environment while prioritizing tasks and fostering a servant leadership approach. Maintain confidentiality and meet physical demands of the role with or without accommodations. Education and Certification
Graduate of an accredited nursing program with current licensure as a Licensed Practical Nurse (LPN) or Registered Nurse (RN) eligible to work in the region. Current AAPC or RHIT certification is required. Experience and Skills
Proven experience in healthcare settings, preferably in prior authorization or medical billing. Strong knowledge of ICD-10-CM, HCPCS, CPT-4 coding, medical terminology, anatomy, and physiology. Familiarity with insurance policies and prior authorization procedures. Excellent verbal and written communication skills for effective interaction with providers, patients, and insurance representatives. Ability to analyze information and make decisions based on policies and regulations. Completion or willingness to complete Mandatory Reporter training within six months of hire. Commitment to compliance programs and ongoing education as required.