Summary

Individual is responsible for the overall verification of inpatient’s health coverage with the patient’s insurance company for the duration of inpatient status and through the transition to a secondary site of care or return home. Reporting to the Manager of Acute Care Coordination, this position is responsible for obtaining authorizations for all inpatient and observation services. This position is also responsible for performing insurance eligibility, documentation of status changes, and reporting insurance status challenges to the patient care team. Other duties include but are not limited to additional tasks related to obtaining final hospital authorization as well as any other clerical needs of the department. The position requires strong communication and organizational skills with an emphasis on quality assurance and timeliness.  Interaction with internal colleagues, providers, and insurance companies on a daily basis is necessary to coordinate patient’s insurance information and complete the verification process in accordance with contractual requirements.

Position Qualifications

Minimum Education: High school graduate or evidence of the equivalent. Preferred Education: Business or Junior College secretarial/clerical training preferred. Minimum Experience: Working knowledge of Microsoft Office, internet, and email. Preferred Experience: 2+ years of experience with prior authorization or claims. Previous use of spreadsheet software and online insurance eligibility platforms is essential. Certifications Preferred: Certified Medical Assistant training or certification