What are the responsibilities and job description for the Authorization Coordinator, Per Diem position at Adventist Health?
Nestled on the Central California Coast, Adventist Health Sierra Vista has been providing care to our community since 1959. Our 162-bed acute care facility includes a Level III Neonatal Intensive Care Unit and county designated trauma center. San Luis Obispo offers the excitement of a lively community while being a fifteen-minute drive from the serenity of Avila Beach, known for their natural hot springs, and Pismo Beach, known for their sand dunes and eucalyptus trees. Featuring a charming downtown, comfortable coastal weather, idyllic views, and an active lifestyle San Luis Obispo offers much to be had.
Job Summary:
Responsible for management of prior authorizations of all activities requiring referrals for procedures, serves as the key coordinator and liaison whose primary role is to expedite the collection process.
Job Requirements:
Education and Work Experience:
- High School Education/GED or equivalent: Preferred
- Associate’s/Technical Degree or equivalent combination of education/related experience: Preferred
Essential Functions:
- Performs daily reconciliation of scheduled procedures, documenting authorization numbers obtained by others, as well as obtaining any authorizations and retroactive authorizations as needed. Serves as the coordinator for scheduled and pre-authorized procedures.
- Reconciles, updates and obtains retroactive authorizations as needed. Performs insurance verification prior to office visit procedures. Interacts with providers and staff to provide guidance and advice with regard to billing, relative to necessary procedures.
- Serves as an authoritative source to reconcile and update the authorization numbers and generate a work list of authorizations needed. Communicates with insurance providers about the patient’s medical necessity, obtain authorization for needed authorizations and reconcile to the authorization database and/or hospital systems.
- Corrects inaccurate information, CPT and ICD9 codes that prohibit pre-authorization being secured and charges being entered into billing system.
- Performs other job-related duties as assigned.
Organizational Requirements:
Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.
Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.
