What are the responsibilities and job description for the AUTHORIZATION COORDINATOR position at Sentara Health?
City/State
Virginia Beach, VA
Overview
Work Shift
First (Days) (United States of America)
Sentara Health is hiring an Authorization Coordinator in Virginia Beach,VA!
Responsible for review of the clinical information received from physicians, department queues and other clinical providers, ensuring clinical data is substantial enough to authorize services for both 1 time visit account types and recurring accounts. Analyzes clinical information to ensure the services requested are authorized according to clinical and payer protocols. Responsible for insurance verification, member benefits, obtaining authorizations and pre-registration for the services requested. Validates accuracy of insurance enrollment information in the system prior to authorizing services, making certain policy is active. Requires knowledge of managed care contracting, clinical protocols and clinical review requirements. Requires knowledge of regulatory and compliance requirements, for both government and commercial payers. Ensures appropriate and accurate information is entered into systems for processing of patient care and reimbursement. Acts as a liaison between patients, physicians, clinical department and insurance companies.
Job Requirements
Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth.
Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve!
keywords: registration, billing, authorizations, health insurance
Job Summary
Responsible for review of clinical information received from Physicians and other Clinical providers ensuring clinical data is substantial enough to authorize services. Analyzes clinical information to ensure the services requested are authorized according to clinical protocols. Responsible for validation of member benefits for the services requested. Validates accuracy of insurance enrollment information in the system prior to authorizing services. Requires knowledge of managed care contracting, clinical protocols and clinical review requirements. Requires knowledge of regulatory and compliance requirements for government payers, self funded and commercial payers. Ensures appropriate and accurate information is entered into claims system for processing of payment.
Related clinical experience as an LPN, such as experience in a physician office, acute care, managed care or clinic setting. Active license required as applicable.
Qualifications:
HS - High School Grad or Equivalent (Required)
Licensed Practical Nurse (LPN) - Nursing License - Compact/Multi-State License, Licensed Practical Nurse (LPN) Single State - Nursing License - North Carolina, Licensed Practical Nurse (LPN) Single State - Nursing License - Virginia Department of Health Professionals (VADHP)
Related experience
Skills
Sentara Healthcare prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
Per Clinical Laboratory Improvement Amendments (CLIA), some clinical environments require proof of education; these regulations are posted at ecfr.gov for further information. In an effort to expedite this verification requirement, we encourage you to upload your diploma or transcript at time of application.
In support of our mission “to improve health every day,” this is a tobacco-free environment.
Virginia Beach, VA
Overview
Work Shift
First (Days) (United States of America)
Sentara Health is hiring an Authorization Coordinator in Virginia Beach,VA!
Responsible for review of the clinical information received from physicians, department queues and other clinical providers, ensuring clinical data is substantial enough to authorize services for both 1 time visit account types and recurring accounts. Analyzes clinical information to ensure the services requested are authorized according to clinical and payer protocols. Responsible for insurance verification, member benefits, obtaining authorizations and pre-registration for the services requested. Validates accuracy of insurance enrollment information in the system prior to authorizing services, making certain policy is active. Requires knowledge of managed care contracting, clinical protocols and clinical review requirements. Requires knowledge of regulatory and compliance requirements, for both government and commercial payers. Ensures appropriate and accurate information is entered into systems for processing of patient care and reimbursement. Acts as a liaison between patients, physicians, clinical department and insurance companies.
Job Requirements
- High School Grad or Equivalent
- Related Associate level degree preferred
- Registration/Billing Experience 2 years
- Health Insurance Verification 2 years
- Health Insurance Authorizations 2 years
- Microsoft Office required
Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth.
Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve!
keywords: registration, billing, authorizations, health insurance
Job Summary
Responsible for review of clinical information received from Physicians and other Clinical providers ensuring clinical data is substantial enough to authorize services. Analyzes clinical information to ensure the services requested are authorized according to clinical protocols. Responsible for validation of member benefits for the services requested. Validates accuracy of insurance enrollment information in the system prior to authorizing services. Requires knowledge of managed care contracting, clinical protocols and clinical review requirements. Requires knowledge of regulatory and compliance requirements for government payers, self funded and commercial payers. Ensures appropriate and accurate information is entered into claims system for processing of payment.
Related clinical experience as an LPN, such as experience in a physician office, acute care, managed care or clinic setting. Active license required as applicable.
Qualifications:
HS - High School Grad or Equivalent (Required)
Licensed Practical Nurse (LPN) - Nursing License - Compact/Multi-State License, Licensed Practical Nurse (LPN) Single State - Nursing License - North Carolina, Licensed Practical Nurse (LPN) Single State - Nursing License - Virginia Department of Health Professionals (VADHP)
Related experience
Skills
Sentara Healthcare prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
Per Clinical Laboratory Improvement Amendments (CLIA), some clinical environments require proof of education; these regulations are posted at ecfr.gov for further information. In an effort to expedite this verification requirement, we encourage you to upload your diploma or transcript at time of application.
In support of our mission “to improve health every day,” this is a tobacco-free environment.
