Gastro Health is seeking an Authorization and Benefits Coordinator to support referral requests, medical service authorizations, and member eligibility/benefits verification. This role works closely with providers, health plans, supervisors, network staff, and claims teams to ensure requests are processed accurately and on time.
Key responsibilities include:
- Entering service requests into the system for authorization tracking
- Communicating with providers to clarify CPT codes, ICD-10 codes, timeframes, and member demographics
- Requesting supporting medical records as needed
- Notifying appropriate parties of routine and urgent requests
- Researching member history for duplication and authorization limits
- Forwarding authorizations to appropriate facilities and departments
- Coordinating approved outpatient procedures and other delegated services
- Maintaining logs, records, and reports for the utilization department
- Answering incoming calls, scheduling office appointments, and updating fax/system information
- Following HIPAA policies and protecting PHI
Requirements & Qualifications
Required qualifications and skills:
- 1 year or more of insurance verification and authorization experience
- Knowledge of insurance carrier requirements
- Computer literacy
- Strong customer service skills
- Data entry proficiency
- Effective communication skills
- Willingness to cross-train
Benefits & Perks
Gastro Health emphasizes a culture built around:
- Compassion
- Collaboration
- Integrity
- Accountability
- Empowerment
- Continuous Improvement
- Positive Attitude
- Customer Focus
Work environment notes:
- Office-based role with moderate noise levels
- Frequent sitting, standing, walking, bending, reaching, and computer use
- Occasional weekends, holidays, or varying shifts may be required
Location
Virginia, US
Employment Type
Not specified
Experience Level
Entry Level
Remote work allowed
No
Posted
3 weeks ago
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