You Will Focus On:

• Verifying benefit eligibility of patient on-line and by telephoning the insurance carrier.
• Reviewing authorization forms for correctness and completeness
• Assisting patients that come into the office with questions regarding their authorizations.
• Appropriately date stamping the authorizations.
• Assisting with filing authorizations appropriately.
• Making necessary corrections and/or additions on any stat or urgent requests. Including appropriate coding.
• Returning any authorizations of a non-urgent or stat nature that needs corrections or additions to the appropriate nursing staff.
• Maintaining office manager inform of needed corrections and/or additions. As well as any and all concern regarding to areas of responsibility.
• May notifies patient of authorization status in letter form and/or phone as directed.
• Scheduling appointment for the patients.
• Effectively communicating with site and practitioner to clarify any questions and update status pertaining to letter and estimate creation as well as authorization process.
• Requesting reports from specialists as needed.
• Create and maintaining pending letters & authorization variance report weekly.
• Assisting and monitoring processing of authorization and enters, updates and closes authorization daily while assuring that: Appropriate internal/external referral providers are utilized. Members are eligible and have benefit coverage. Correct CPT/ICD-10 codes have been entered. Accurate records of all dates and other required fields is entered. Supporting clinical data for the referral is entered. All referrals are processed according to policy and procedures.
• Printing and mailing authorizations to providers, patients, HMO’s and facilities as needed.
• Processing referrals for Durable Medical Equipment and may coordinates Home health Services according to established policies, procedures and guidelines.
• Coordinating, identifying and routing referrals that require review to licensed Care Management staff who arranges outside physician medical review as appropriate.

The Skills, Experience & Education You Bring:

• Strong interpersonal and customer service skills
• Experience with an electronic medical record, MS word, Excel, Outlook and the ability to learn new applications
• Ability to communicate (both internally and externally) clearly and consistently with established procedures and guidelines
• High School Diploma or GED
• EMR experience - EPIC preferred
• 1+ year of experience as a Medical Authorization Coordinator

You Share our Mission & Values

• You are passionate about improving the healthcare experience and want to be part of the Altais mission.
• You are bold and curious- willing to take risks, try new things and be creative.
• You take pride in your work and are accountable for the quality of everything you do, holding yourself and others to a high standard.
• You are compassionate and are known as someone who demonstrates emotional intelligence, considers others when making decisions and always tries to do the right thing.
• You co-create, knowing that we can be better as a team than individuals. You work well with others, collaborating and valuing diversity of thought and perspective.
• You build trust with your colleagues and customers by demonstrating that you are someone who values honesty and transparency.