Coordinator, Medical Staff Office

Job Summary: We are seeking an experienced Authorization Coordinator to support our company operations by following company policies and procedures. This individual will be responsible for identifying, developing, and maintaining referral sources and potential clients to bring in additional business for the company.

This role requires a multi-tasked individual with computer and general office technology skills, excellent communication skills, and efficiency. The Authorization Coordinator will ensure smooth operation of the organization, its core values, and mission by being a friendly, welcoming ambassador to the organization's clients, staff, and visitors.

Key Responsibilities:

• Communicate with payor representatives to foster partnership and collaboration
• Manage medical records requests, ensuring timely processing and adherence to privacy and regulatory standards
• Process Improvement: Assist in the development and implementation of best practices for authorization management in collaboration with the billing team
• Utilize Key Performance Indicators (KPIs) to track authorization metrics and improve efficiency in the authorization process
• Stay informed of payer-specific requirements for authorization, documentation, and medical necessity, ensuring all necessary documentation is submitted for approval
• Communicate with families about the importance of adhering to the recommended service intensity to ensure the best outcomes for their child's therapy

Credentialing:

• Manage the credentialing process, ensuring all providers meet regulatory requirements and maintaining up-to-date documentation for compliance
• Ensure timely submission of applications and supporting documents to insurance companies and other credentialing entities
• Maintain accurate and up-to-date records of all credentialing and re-credentialing activities

Collaboration and Resolution:

• Collaborate with the billing department to resolve billing discrepancies and aging issues, including identifying outstanding claims, following up on denials, and ensuring timely payment resolution

Community Engagement:

• Represent the organization through participation in community events

General Office Tasks:

• Perform general office tasks such as filing, scanning, and organizing

Requirements:

• Experience in medical/behavioral/mental health/therapy-related organizations
• Commercial and Medicaid authorization experience
• Excellent verbal and written communication skills to explain complex and/or confidential information
• Strong administrative, organizational, and problem-solving skills
• Developing standards, promoting process improvement, reporting skills
• Proficient in Microsoft Office

This is a full-time position, working Monday through Friday, 8:30 a.m. Travel is minimal and primarily local during the business day.