The Authorization Coordinator is responsible for creating and maintaining current insurance verification, admission notifications, and/or pre-certifications for services provided to all bedded patients within the Baptist Health Care hospital system, including services rendered by BHC’s employed physician enterprise. These functions include: verifying insurance eligibility for all payers, creating an estimate for out of pocket patient expense, making notification of admission to the facility for both the hospital and the physician enterprise (as applicable), maintaining the authorization with the payer throughout the entire length of stay, working closely with Case Management to request clinical information to be faxed to the payer for utilization review, and obtaining prior authorizations from all providers when inpatient surgeries. The Authorization Coordinator will also work closely with Case Management’s discharge planning team to obtain prior authorizations for the BHC Senior Health program when patients are discharged from a BHC facility to a skilled nursing managed by our organization, to protect the reimbursement of the downstream department. This position will utilize numerous patient access and financial services systems in order for patient demographics and authorization information to be maintained consistently throughout all.
The person in this position works under general supervision, is responsible for various shifts, may be subject to over 40 hours per week and/or callback as required, and may also be required to remain on campus immediately before, during, and after severe weather and/or disasters.
Requirements for Authorization Coordinator:
Requirements for Authorization Coordinator II: