Patient Authorization Coordinator

4 weeks ago

Angeles City, Central Luzon, Philippines SuperStaff Full time

The Patient Authorization Coordinator is the employee that interacts and works closely with many others employees. This person also interacts with the clinical sales specialists, physicians, nurses, office staff, case managers for all manufacturers, and the patient/patient family. This position is at the corporate office. The Patient Authorization Coordinator provides continual verification and eligibility for all existing patients, under the direction of the DME Operations Supervisor. The DME Re-Authorization Coordinator contributes greatly to the overall satisfaction of our customers, vendors, and business associates.

Requirements
  1. Re-authorization dates and tasks are entered into QS1 and/or Brightree system by the DME Case Management Billing Coordinator which allows for a monthly tickler report for the reauthorization process.
  2. Requests clinical data from the patient's Endocrinologist or other physician's office as necessary for the re-authorization process.
  3. Submits request for re-authorization to the insurance company.
  4. Timely follow-up on requests for re-authorization dates.
  5. Documents all pertinent information on the case management authorization form and in Brightree and the QS1 system.
  6. Creates tasks in Brightree for future authorizations.
  7. Adheres to formulary guidelines and follows protocol in place.
  8. Requests interim supplies as necessary and appropriate.
  9. Performs other related duties as required and assigned.

Qualifications

  1. Strong verbal and written communication skills are required.
  2. Must be knowledgeable in basic office operations and be able to perform multiple tasks simultaneously.
  3. Must be able to work under pressure, delineate priorities when the workload is abundant.
  4. Must be able to represent the company in a professional manner.
  5. Must maintain HIPAA (Health Insurance Portability and Accountability Act) compliance in accordance with the provisions outlined in the company's Employee Manual and HIPAA manual and understand their obligations under the Privacy Rule.
  6. Able to perform the essential duties of this position without posing a "direct threat" to the health or safety of self or others.
  7. EDUCATION/EXPERIENCE
  8. High School graduate, or equivalent.
  9. One year of experience, in a similar position, preferred.
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