Authorizations Coordinator

  • Company: Hospital Corporation of America
  • Location: Saint Petersburg, Florida
  • Posted: October 19, 2017
  • Reference ID: 01380-8718
West Florida Shared Services
HCA West Florida is a comprehensive network of 16 hospitals with 21 ER locations, 14 surgery centers, 21 graduate medical education programs and a complete continuum of specialized health programs and services that meet the healthcare needs of residents and businesses.
In 2016, we treated more than 1.2 million patients and provided an economic benefit to the area of more than $2 billion.
• 16 hospitals on 18 Campuses
• 14 ambulatory surgery centers
• an integrated regional lab
• a consolidated service center

In 2016, our hospitals in west Florida provided care for 686,004 patients through ER visits and 216,927 patient admissions and observations.
Our more than 3,301 physicians and 18,811 employees provide the quality foundation for delivering care to our patients safely , effectively and compassionately.

Authorization Coordinator

The UR Coordinator provides support to the Centralized Utilization Review unit and staff. This position has responsibility for oversight of timely and accurate verification of insurance authorization and certification for hospital days; coordinates initial, continued stay and denial reviews with UR RNs as required; maintains communication with payers/facilities and documents elements of the process as applicable. Provides administrative office secretarial support to management/department team members as necessary.

MAJOR ROLE RESPONSIBILITIES
  • Maintain documentation including but not limited to authorization/certification numbers, denials, and communication notes
  • Monitors phone and secure fax/email and communicate to UR nurses
  • Monitor authorization /certification report
  • Send clinical information to insurance plans
  • Communicate with facilities as needed
  • Assist UR nurse staff with concurrent denials
  • Adheres to established policy and procedure and standards of care; escalates issues through the established Chain of Command timely

Qualifications:
Position Requirements:

Education - High School Diploma, prefer some college

Experience - 2 years as an administrative aide or secretary, acute hospital setting or case management experience preferred. Payer experience preferred.

SPECIAL QUALIFICATIONS
• Requires ability to sit for extended periods of time and work in a confined place
• Requires excellent organizational skills, ability to proactively prioritize needs and effectively manage time
• Knowledge of Case Management process and the Utilization Review process
• Ability to establish and maintain collaborative and effective working relationships
• Ability to communicate effectively in oral, written, and electronic formats
• Demonstrates analytical and critical thinking abilities with pro-active decision making and negotiations skills
• Proficient computer skills, including knowledge of Microsoft office suite
• Cu stomer service oriented; positive, enthusiastic, helpful personality

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