Precertification Coordinator

Primary duties include gathering prior authorization approvals, follow up during approval process, and other administrative tasks related to acquisition and billing.

• Manage prior authorization determinations in a timely manner.
• Knowledge of insurances and responsible for updating biologics department of any changes, concerns, or new rules.
• Communicate status of authorizations and results to offices.
• Assists with developing and implementing prior-authorization work flows, policies and procedures.
• Adapts departmental plans and priorities to address business and operational challenges
• Maintains patient confidentiality; complies with HIPAA and compliance guidelines established by Allergy Partners.
• Maintains detailed knowledge of practice management, electronic medical record, and other computer software as it relates to job functions.
• Attends all regular staff meetings.
• Completes all assigned AP training (such as CPR, OSHA, HIPAA, Compliance, Information Security, others) within designated timeframes.
• Complies with Allergy Partners and respective hub/department policies and reports incidents of policy violations to a Supervisor/Manager/Director, Department of Compliance & Privacy or via the AP EthicsPoint hotline.

Educational Requeriments

High school diploma required.

Clinical license or certification a plus but not required.

Qualifications

• Minimum of two years of experience in a medical office.
• Familiarity with insurance: medical and pharmacy benefits.
• Knowledge of prior authorizations and how to obtain them.
• Administrative knowledge of buy and bill practice.
• Working knowledge of common biologics utilized in an allergy practice.
• Comfortable using email, word processing and interacting with Internet applications.
• Working knowledge of practice management and electronic health record software. GE Centricity is a plus.
• Ability to perform multiple and diverse tasks simultaneously with accuracy and efficiency.
• Neat, professional, and organized
• Strong written and verbal communication skills.