Authorization Coordinator

The Central Authorization Department, also known as CAD, focuses on prior authorization submissions for all commercial and military insurance, if the referring clinic has not submitted anything prior to scheduling an appointment, obtaining referral and prior authorization retrieval and follow up, as well as verifying insurance eligibility and updating insurance information on Ramsoft.

NOTE: Job Descriptions may be revised to suit business needs at any time.

RESPONSIBILITIES:

• As referral comes, ensure all proper ICD 10 and CPT codes are properly applied. Verify all prior approval for procedures are in order and approved.

• Receiving incoming authorizations from all insurance companies including work comp and department of corrections.

• Scanning documents, transmitting (via fax or email) to insurance companies.

• Distribute incoming correspondence to the proper departments.

• Prepare authorizations with proper ICD10 and CPT codes, including all supporting documentation needed by the insurance company.

• Initial submission and follow up of prior authorizations scheduled or endorsed to CAD.

• Verification of active insurance using the online portals or calling in the insurance company and updating the information within the RIS system.

• Maintain good business relationship with all the other clinics to ensure daily tasks run smoothly.

SKILLS:

• Must possess strong customer service skills.

• Be proficient in use of PC and Windows OS

• Familiar with Medical Terminology, CPT & ICD-10 Coding.

• Able to communicate in a professional manner.

• Should be able to complete multiple tasks simultaneously.

• Must possess basic typing skills to input various data into the RAMSOFT system.

• Must be familiar with all equipment and processes needed to complete duties.