What are the responsibilities and job description for the Authorization Coordinator position at Radiation Billing Solutions, Inc?
Job Description
Job Description
Description :
The Authorization Coordinator will be responsible for effectively acquiring Radiation Oncology authorizations, working denied authorizations and submitting appeals as needed. The Authorization Coordinator must be able to handle multiple, simultaneous tasks effectively and efficiently and is expected to demonstrate ENCORE in all communications.
Essential Duties and Responsibilities
- Submit referral, precertification and / or authorization for radiation oncology services from schedules two weeks out and checking back for add ons within 72 hours of exam to positively impact DSO for 100% of patients that require authorization.
- Average time from precertification and / or authorization request notification and submission to approval should not exceed 5 business days
- Review client queues and schedules daily to identify patients requiring authorization per payer requirements.
- Review guidelines to confirm if no auth is required that exam meets medical necessity.
- Communicate with physician / clinical staff on authorization issues and / or pre-certification requirements by the patient's insurance carriers.
- Identify and address denied authorizations to include the appeal process and denial resolution.
- Notify Billing Departments of any special instructions, for example, Skilled Nursing Facility or Inpatients. Demonstrated by
- Document accurate authorization activity to reflect work performed in physician / hospital system, billing system, and other systems as needed for reporting and tracking.
- Create relationships at the payer level to assist with initial authorization approval, reduce the need for peer-to-peer, and guarantee the successful reversal of authorization denials.
- Participate in all required meetings with client / personnel, become one of the team.
- Review processes and provides suggestions for process improvements and efficiencies.
- Stay up to date on all CPT / HCPCS / ICD-10 code changes and all payer policy authorization requirements.
- Exhibit ENCORE values.
Other Expectations / Skills
ENCORE Values
E ncourage others’ success
N ew ideas; anticipate problems
C reate financial value for our clients
O wnership towards a solution
R each Life Balance
E mbody a positive approach
Requirements :
Physical Demands and Work Environment : The physical demands described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the functions.
Disclaimer : This job description in no way states or implies that these are the only duties to be performed by the employee(s) of this position. Employees will be required to follow any other job-related instructions and to perform any other job-related duties requested by any person authorized to give instructions or assignments. All duties and responsibilities are essential functions and requirements and are subject to possible modification to reasonably accommodate individuals with disabilities.
The company is an equal opportunity employer, drug-free workplace, and complies with ADA regulations as applicable.
