EmpowerMe Wellness
Authorizations Coordinator
EmpowerMe Wellness, Austin, Texas, us, 78716
Overview:
Authorizations CoordinatorReports To:
Authorizations ManagerExempt Status:
Non-ExemptDirect Reports:
NoDepartment:
Revenue Cycle ManagementAbout Us:A tech-enabled, multi-service healthcare organization, EmpowerMe Wellness is on a mission to improve the lives of seniors. We enrich senior living communities nationwide through our fully integrated on-site therapy, diagnostic, pharmacy, and nurse practitioner services. With a team of more than 3,000 clinicians and professionals, we focus on improving wellness and driving positive outcomes from a place of deep compassion and expertise. Headquartered in St. Louis, Missouri, EmpowerMe has a presence in hundreds of communities across the country. You can find out more about us at empowerme.com.Responsibilities:Position Summary:As an Authorization Coordinator with EmpowerMe you will be responsible for obtaining prior authorizations and other health information management tasks. Key functions of this role will involve submitting and obtaining prior authorizations from multiple insurance plans across the country, entering authorization details into the EMR and communicating with Clinic Directors. The ability to review and collect information in a thorough and detailed manner, as well as timely response and communication are critical to the success of this position.Essential Duties include the following:The following duties are normal for this position. This list is not to be construed as exclusive or all inclusive. Other duties may be required and assigned. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Review information in the billing software/ EMR to ensure all necessary information/documents are available to start the authorization process.Submit prior authorizations and/or in-network exception/GAP requests by calling the insurance, faxing in the prior authorization request and/or submitting on insurance portal.Obtain prior authorization/GAP exceptions within the assigned states/regions.Follow-up and document the status of prior authorizations in a timely manner.Obtain approval letters from insurance companies, review for accuracy and input theauthorization details in the appropriate billing software/EMR in a complete and accuratemanner.Communicate with the Clinic Director on the status of the authorization and answer anyquestions.Perform general business office work including answering phones, retrieving voice mail and returns calls to patients and providers.Organize and scan and/or save all paper and/or electronic documents received from outside sources into the EMR accurately.Review and update patient electronic record ensuring accuracy of information and identify any missing data.
Qualifications, Education and/or Experience:To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and abilities required.Bachelors degree or Associates degree plus 1 year of professional office experience, or High School diploma or GED plus 3 years professional office experience (professional office experience in healthcare setting is preferred).Must exhibit a very high level of thoroughness & detail orientation.Goal- and result-oriented, as well as self-motivated with a sense of professional curiosity, desire to learn new things, and to find / recommend solutions to problems.Excellent communication and interpersonal skills required.Must have the ability to work in a fast-paced environment, remain calm in stressful situations, to be flexible, to work well with many interruptions and have skill in multi-tasking.Must exhibit and promote a high level of customer service, hospitality, curiosity and friendliness towards all clients, visitors, coworkers.Quickly adapts to change and takes a proactive approach to problem solving.Knowledge and understanding of HIPAA and CMS guidelines.Ability to analyze, interpret and draw inferences from research findings and prepare reports.Knowledge of and experience with insurance benefit coordination, medical credentialing, and medical billing.Working knowledge of clinical and/or Agency operations and procedures.Ability to use independent judgment to manage and impart confidential information.Database management skills including querying, reporting, and document generationComputer Skills:Proficiency in Internet browsers (e.g., Explorer, Chrome, Fire Fox), as well as advanced knowledge of Microsoft Office programs: Outlook, Excel, Word, and Publisher applications. Experience in working with various EMR and medical billing systems.
Work Environment & Physical Demands:The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to sit at a desk and work on a computer. Must be able to lift 20 pounds at a time. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.This employer is an Equal Opportunity Employer. In compliance with the Americans with Disabilities Act, the employer will provide reasonable accommodations to qualified individuals with disabilities and encourages prospective employees and incumbents to discuss potential accommodations with the employer.
Authorizations CoordinatorReports To:
Authorizations ManagerExempt Status:
Non-ExemptDirect Reports:
NoDepartment:
Revenue Cycle ManagementAbout Us:A tech-enabled, multi-service healthcare organization, EmpowerMe Wellness is on a mission to improve the lives of seniors. We enrich senior living communities nationwide through our fully integrated on-site therapy, diagnostic, pharmacy, and nurse practitioner services. With a team of more than 3,000 clinicians and professionals, we focus on improving wellness and driving positive outcomes from a place of deep compassion and expertise. Headquartered in St. Louis, Missouri, EmpowerMe has a presence in hundreds of communities across the country. You can find out more about us at empowerme.com.Responsibilities:Position Summary:As an Authorization Coordinator with EmpowerMe you will be responsible for obtaining prior authorizations and other health information management tasks. Key functions of this role will involve submitting and obtaining prior authorizations from multiple insurance plans across the country, entering authorization details into the EMR and communicating with Clinic Directors. The ability to review and collect information in a thorough and detailed manner, as well as timely response and communication are critical to the success of this position.Essential Duties include the following:The following duties are normal for this position. This list is not to be construed as exclusive or all inclusive. Other duties may be required and assigned. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Review information in the billing software/ EMR to ensure all necessary information/documents are available to start the authorization process.Submit prior authorizations and/or in-network exception/GAP requests by calling the insurance, faxing in the prior authorization request and/or submitting on insurance portal.Obtain prior authorization/GAP exceptions within the assigned states/regions.Follow-up and document the status of prior authorizations in a timely manner.Obtain approval letters from insurance companies, review for accuracy and input theauthorization details in the appropriate billing software/EMR in a complete and accuratemanner.Communicate with the Clinic Director on the status of the authorization and answer anyquestions.Perform general business office work including answering phones, retrieving voice mail and returns calls to patients and providers.Organize and scan and/or save all paper and/or electronic documents received from outside sources into the EMR accurately.Review and update patient electronic record ensuring accuracy of information and identify any missing data.
Qualifications, Education and/or Experience:To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and abilities required.Bachelors degree or Associates degree plus 1 year of professional office experience, or High School diploma or GED plus 3 years professional office experience (professional office experience in healthcare setting is preferred).Must exhibit a very high level of thoroughness & detail orientation.Goal- and result-oriented, as well as self-motivated with a sense of professional curiosity, desire to learn new things, and to find / recommend solutions to problems.Excellent communication and interpersonal skills required.Must have the ability to work in a fast-paced environment, remain calm in stressful situations, to be flexible, to work well with many interruptions and have skill in multi-tasking.Must exhibit and promote a high level of customer service, hospitality, curiosity and friendliness towards all clients, visitors, coworkers.Quickly adapts to change and takes a proactive approach to problem solving.Knowledge and understanding of HIPAA and CMS guidelines.Ability to analyze, interpret and draw inferences from research findings and prepare reports.Knowledge of and experience with insurance benefit coordination, medical credentialing, and medical billing.Working knowledge of clinical and/or Agency operations and procedures.Ability to use independent judgment to manage and impart confidential information.Database management skills including querying, reporting, and document generationComputer Skills:Proficiency in Internet browsers (e.g., Explorer, Chrome, Fire Fox), as well as advanced knowledge of Microsoft Office programs: Outlook, Excel, Word, and Publisher applications. Experience in working with various EMR and medical billing systems.
Work Environment & Physical Demands:The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to sit at a desk and work on a computer. Must be able to lift 20 pounds at a time. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.This employer is an Equal Opportunity Employer. In compliance with the Americans with Disabilities Act, the employer will provide reasonable accommodations to qualified individuals with disabilities and encourages prospective employees and incumbents to discuss potential accommodations with the employer.