An Authorization Coordinator is responsible for verifying coordinating benefits, patient-eligibility process and addressing patient’s concerns relating to authorization and turnaround. Typical duties that can be found highlighted in the Authorization Coordinator Resume include some or all of the following – interviewing and assisting patients with their authorization documents, monitoring and tracking authorization of patients, informing supervisors about expired dates, verifying benefits with the insurance provider to ensure correct payment for services, obtaining and reviewing insurance authorization referrals, and maintaining appropriate logs as per state or federal requirements.
The education requirement may vary based on the employer preference and job setting, but most of the candidates applying for this role have a college degree preferably with a medical coding certification or experience. Work experience in insurance and authorization will be given due weightage. Skills include demonstrating a strong communication skill, the ability to identify even the minutest mistake and close attention to details.
Headline : To continue to grow within the healthcare industry while learning different aspects of the field to better service, and impact all areas for improvement.
Skills : Oracle, Customer Service, Sales, Purchasing, Microsoft Office.
Description :
Responsible for the daily processing of TRICARE referrals for TRICARE beneficiaries and assisting personnel needing guidance in the processing of TRICARE referrals.
Resolve escalated inquiries which could include: Referral, Authorization & Letter processing.
Entering notifications & providers' status of an existing notification, and determining if notification is required; Complete notification wizard along with coding;
Provide excellent customer service to both providers and enrollees; Constantly meet established productivity, schedule adherence, and quality standards while maintaining good attendance;
Assist with faxes and emails; Basic tasks are completed without review by others; Supervision/guidance is required for higher-level tasks.
Evaluate process flows, recommending and implementing process improvement opportunities
Assisted providers with contracting issues and resolution by reviewing contract details and inform in NDB/PHycom daily and routing to the correct provider installation specialist.
Experience
5-7 Years
Level
Executive
Education
Psychology
Authorization Coordinator Resume
Objective : 7+ years customer service and front desk reception, as well as 2+ years in the medical field. Worked in a Medical office and helping the patients and ensuring our staff and environment exceeded their expectations every visit.
Skills : Microsoft Office.
Description :
Submitting requests for authorizations for HMO insurances and Workers Compensation claims.
Retrieving approvals and denials for submitted requests.
Faxing documentation and orders to authorized facilities and scheduling STAT requests upon retrieval.
Notifying patient via telephone of approval or denials to the requests; providing location information for patients to schedule approved requests (Physical therapy, Occupational therapy, MRI/CT Scan, Ultrasounds).
Scheduling patient appointments for in-house authorizations and/or follow-ups with the physicians Adding CPT codes to referrals to ensure the visit was covered by contracted insurance, maintaining patient privacy with regulations.
Develop and maintain cooperative working relationships with health plans, medical groups, insurances & other medical offices.
Manage patient inquiries regarding referral status & the authorization process & any related issues in a courteous & professional manner.
Experience
2-5 Years
Level
Junior
Education
Diploma In General
Sr. Authorization Coordinator Resume
Summary : To secure a position with a well-established organization that will enable me to use strong organizational skills, educational background, and ability to work well with others that will lead to a lasting relationship in mental health.
Skills : Explanation of Benefits, Excellent Customer Service Skills, Strong written communication, documentation and organization skills.
Description :
Obtained prior authorizations for new and established patients.
Upgraded and downgraded prior authorizations as needed per the radiologist request.
Efficiently responded to priority issues such as STATS to ensure proper patient care per individual case.
Acted as point of contact for over physicians in a large radiology medical facility, maintaining personal networks and building positive relationships
Responsible for the timely verification of medical insurance benefits for the service.
Interfaced directly with a diverse population of patients, responding to various inquiries and concerns.
Updated patient demographics, follow-up on patient referrals, inputting final diagnosis codes
Assisted patients with COB issues, reviewing account information and explain charges and other related inquiries from patients.
Experience
7-10 Years
Level
Senior
Education
Liberal Arts
Authorization Coordinator II Resume
Headline : Seeking a medical administrative position to utilize knowledge learned. Experienced in office administration, authorization submission, claims processing, coding, scheduling patients, detail oriented, team player, reliable, and works well under pressure.
Skills : Microsoft Office, Excel, Outlook, Management, Medical Terminology, Office Administration, Office Manager, Accounting, Icd10.
Description :
Ensure that patients have proper authorization and assure that insurance company requirements are met.
Communicating and working closely with doctors and nurses.
Arrange Peer-to-Peer discussions between physicians and insurance companies.
Creating authorization forms by electronic and/or hard copy, downloading records Organize and prioritize workload to assure verification and authorization are completed on a timely basis.
Investigate and expedite approval, deferred and denied services.
Review denials and submit new authorization with a requirement from insurance.
Updated patient demographics, follow-up on patient referrals, inputting final diagnosis codes
Experience
5-7 Years
Level
Executive
Education
Real Estate Sales
Authorization Coordinator I Resume
Headline : An enthusiast Customer Service Professional for more than 12 years within call center environment for various domains such as Healthcare and Medical Supplies Companies and for Telecommunications Companies.
Skills : Customer Service, Microsoft Office Suite 2010/2013,.
Description :
Receive phones calls and faxed referral request from providers.
Provides referral request authorization to external providers per UM Departmental Policy and Procedures and specific contracted Client's process.
Appropriately forwards all referral requests to the next level of review.
Coordinates approved outpatient surgical procedures in the specialist office and/or outpatient facilities with health plan's authorization department when applicable.
Coordinates approved services with Home Health Providers, Plan discharge Planners and Plan Members as delegated or required by Plan.
Updated patient demographics, follow-up on patient referrals, inputting final diagnosis codes
Interfaced directly with a diverse population of patients, responding to various inquiries and concerns.
Experience
5-7 Years
Level
Executive
Education
Diploma
Lead Authorization Coordinator Resume
Headline : A challenging position in the medical field or any related position with an organization which will encourages the growth of my professional skills.
Skills : Self-motivated person with great.
Description :
Full-time Evaluates insurance information for new and established patients.
Obtains physicians referrals, authorization, and pre-certifications for established and new patients Verify patient's benefits from 1 week out and work on add on's.
Insurance verification notification for inpatient and outpatient services.
Establishes payment responsibilities for office visits and procedures and private pay.
Reviews outstanding balances of appointed patients and annotates any payment requirement on the patient's data screen for coding specialist/checkout receptionist.
Patient's Insurance information is entered correctly for billing.
Ensure that patients have proper authorization and assure that insurance company requirements are met.
Experience
5-7 Years
Level
Executive
Education
Bachelor Of Science
Prior Authorization Coordinator Resume
Headline : Seeking to hold a job position in an esteemed institution, where I can use my experience and skills to play an important role in the growth of the department and can utilize all possible available opportunities to pursue a long term career.
Skills : Medical Terminology, Medical Records, Medical Coding, Coordinator.
Description :
Perform financial counseling process with the patient's prior to admission, which includes patient financial obligations and billing practices.
Collect applicable deductible, Co-payments, Co-Insurance prior to admission by check or credit card number if applicable.
Perform insurance verification process; obtains initial and subsequent pre-authorization for services as described by operations case management.
Responsible for reports to determine whether patients are eligible for insurance on file.
Cross trained for the following positions: Intake: Receives and coordinates all referrals that come in.
Coordinates scheduling and staffing with scheduler, Do all the data entry for referrals received and accepted, send out templates of the new patient being accepted.
Establishes payment responsibilities for office visits and procedures and private pay.
Experience
5-7 Years
Level
Executive
Education
High School Diploma
Asst. Authorization Coordinator Resume
Objective : Highly motivated career-focused individual with the ability to exceed expectations to become part of a winning team. Over 15 years' experience in the medical field. Although I chose to pursue the less clinical aspect of health care.
Verified eligibility and benefits for all new patients that come on service with our company..
Responsible for the up keeping of the ongoing authorizations of the patients already on service.
Dedicated to meet the expectations and requirements of our patients.
Resolved and answered questions regarding their statements.
Assisted outgoing calls to patients for payments on their account that are past due.
Full-time Evaluates insurance information for new and established patients.
Coordinates approved services with Home Health Providers, Plan discharge Planners and Plan Members as delegated or required by Plan.
Experience
2-5 Years
Level
Executive
Education
Diploma
Authorization Coordinator III Resume
Summary : Public Health Nurse in the Philippines for 5 years, rendering comprehensive care to variety of clients including the whole community, with a job-scope of leadership and management to my subordinates including non-licensed health workers, student nurses and volunteers.
Skills : Proficient in Microsoft and Excel.
Description :
Provide an outbound call to medical office, clinic, hospital, and facilities to verify the prescription and/or treatment of patients.
Provide an outbound call to health insurance companies to verify the eligibility of patients.
Accept inbound calls regarding authorization, denial, and expiration of treatments and medications.
Coordinates delivery of treatment and medications of patients as per eligibility.
Maintains confidentiality of patient's medical records and insurance policy.
Accept in ound calls from patient inquiries, modification, and clarfications regarding their medications and schedule of treatment.
Interfaced directly with a diverse population of patients, responding to various inquiries and concerns.
Experience
7-10 Years
Level
Management
Education
BS In Nursing
Associate Authorization Coordinator Resume
Objective : Excellent oral and written communication skills Strong ability to write clear accurate case notes, correct authorizations and complete other paperwork thoroughly and accurately. Profound ability to maintain program confidentiality and treat each individual with dignity and respect.
Skills : Microsoft, Excel, Outlook, Customer Service Skills, Medical Terminology, Data Entry, Patient Care, Medical Insurance.
Description :
Composed authorizations from telephonic and faxed requests from PCP's, specialists, hospitals and ancillary providers.
Completed authorization screens with accurate information and determine status of authorization.
Responsible for questionable coverage issues or issues requiring additional clinical review to appropriate clinical staff.
Conducted follow up regarding clarification of written/fax requests.
Generated and faxed request for clinical information for request that require clinical review.
Educated providers with regards to Plan policies/procedures and Plan benefits .
Interact with patients to obtain insurance information, give benefit information, discuss payments, and appointments.
Experience
2-5 Years
Level
Junior
Education
Graphic Design
Authorization Coordinator/Supervisor Resume
Objective : To continue to grow within the healthcare industry while learning different aspects of the field to better service, and impact all areas for improvement. An opportunity for growth and development, would be preferred.
Skills : Oracle, Customer Service, Sales, Purchasing, Microsoft office.
Description :
Coordinating authorization requests regarding surgeries, rehabilitation, consults and follow ups, etc.
Collecting information from providers needed to process authorization requests.
Forwarding information to nurses and/or medical directors to have requests finalized.
Data entry of patient and provider information.and Claims processing for all capitated services.
Determined prior authorizations for procedures done in-office and outpatient procedures.
Verified patients' eligibility and claims status with insurance agencies.
Assist the Utilization Management team with research of prior authorizations.
Experience
2-5 Years
Level
Junior
Education
General Education
Authorization Coordinator Resume
Objective : To an organization that offers challenges and the opportunity to grow within the company, where objectives are clearly established and the tools to reach such goals are provided, to believe in being an asset to the organization I work with.
Skills : Bookkeeping, Microsoft Office Suite, Supervisor.
Description :
Answers call, schedules and cancels patient appointments. and Schedules any necessary follow up appointments.
Reviews computerized appointment templates to determine the availability of appointment types and slots.
Identifies analyzes and resolves a variety of scheduling issues.
Documents transactions in appropriate medical management systems.
Performing all insurance verification and pre-authorization functions.
Assisting with the identification and correction of errors on denied claims as they are received from the Patient Account Representative.
Contacting adjusters and nurse case managers to follow up on requests for authorizations.
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