Authorization Coordinator & Patient Access, Case Management Department, Full Time, Job ID 1687695

Job Description

Job Description

Position Summary

The Authorization Coordinator & Patient Access is responsible for ensuring a seamless patient experience from initial contact through admission or scheduling, while securing timely and accurate insurance authorizations. This role serves as a critical link between patients, providers, payers, and hospital departments to support efficient operations, regulatory compliance, and optimal reimbursement.

Key Responsibilities:

Patient Access Functions

• Greet patients and families in a courteous and professional manner
• Register patients accurately including demographics and insurance information
• Verify insurance eligibility and benefits
• Collect co-pays, deductibles, and other patient financial responsibilities
• Explain registration forms, consent documents, and patient rights
• Maintain HIPAA compliance and patient confidentiality
• Resolve registration errors and update patient records
• Coordinate admissions, discharges, and transfers as applicable

Authorization & Referral Functions

• Obtain prior authorizations and pre-certifications for services
• Review physician orders for completeness and medical necessity
• Communicate with insurance companies and managed care organizations
• Track authorization status and follow up to prevent delays or denials
• Document authorization numbers and payer communications
• Collaborating with clinical staff, case management, and billing
• Assist in denial prevention by ensuring payer compliance

Required Knowledge & Skills:

• Knowledge of medical terminology and insurance processes
• Strong attention to detail and communication skills
• Ability to multitask in a fast-paced healthcare environment
• Hospital or acute care experience (preferred)
• CRCR, CHAA, or similar certification (preferred)
• Bilingual skills as applicable (preferred)

Education/Experience/Licensure/Technical/Other:

• Education: High School Diploma or Equivalent (Associate's Degree preferred)
• Experience (Type & Length): 1-3 years in patient access, registration, or authorization

• Software/Hardware:
• License/Certification: Other:

Must clear background and drug test required.