Authorization Coordinator, Insurance Services

Essential Accountabilities

Reflects the job's main responsibilities and is not intended to be an exhaustive list of all duties performed; therefore, its content does not restrict management's right to assign or reassign duties and responsibilities to individuals in this job.

• Researches and processes prior authorization requests.

• Verifies eligibility and benefits of members.

• Performs data entry, prioritizes, and processes auto authorizations.

• Monitors and follows-up on open or pended authorizations.

• Enters demographic information into the system and updates information.

• Prepares and maintains logs and reports.

• Responds to and processes urgent/stat authorization requests.

• Maintains confidentiality and discretion in use of member information.

• Performs other job-related duties as assigned.

Knowledge, Skills, and Abilities

• Knowledge of HMO commercial line of business.

• Knowledge of HMO prior authorization requests, referral process, eligibility verification, and health plan benefits.

• Ability to operate office equipment (e.g., telephone, fax, computer, scanner, etc.).

• Skills in preparing and maintaining records, writing reports, and responding to correspondence.

• Thorough and prompt follow-up up to resolution.

• Excellent oral and written communication skills with proper use of grammar, spelling, and punctuation.

• Ability to read, understand, and follow oral and written instructions.

• Ability to multi-task, work with frequent interruptions, and meet deadlines.

• Ability to establish and maintain effective working relationships.

• Detailed and goal oriented.

• Ability to work effectively in a team environment.