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Reimbursement Coordinator Associate

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Job Description - Reimbursement Coordinator Associate

At UK King's Daughters, we’re not just a healthcare facility — we’re a family of dedicated professionals who share a passion for making a meaningful difference in the lives of our patients. We’re more than just a place to work; we’re a place to grow, thrive, and contribute to our community.

Job Description:

Job Summary


Responsible for coordinating insurance authorization and pre-certification for scheduled medications and laboratory tests. Communicates denials to appropriate parties as necessary. Ensures timely and accurate processing of all insurance-related documentation. Collaborates with clinical and administrative teams to support patient care and access. Maintains compliance with regulatory and payer requirements.




Essential Functions


• Tracks, obtains, and extends authorizations in a timely manner.


• Records insurance information using standardized documentation practices.


• Obtains, interprets, and submits clinical documentation for prior authorization.


• Obtains and documents prior authorization approvals from insurance companies.


• Communicates authorization status or delays to providers and clinical staff.


• Follows up on denied authorization requests.


• Facilitates peer-to-peer conversations between insurance carriers and providers.


• Supports claim denial appeal efforts related to prior authorizations.


• Performs other duties as assigned.




Education Requirement


High school diploma or equivalent experience






Experience Requirement


0-2 years of experience in a healthcare, clinical setting, or a relevant area




An equivalent combination of education and experience may be considered.


All experience must be paid and in the same related field.


Part-time and PRN experience will be prorated based on hours worked per week.


Volunteer work and internships for academic credit are not counted.




Certifications & Licensures


N/A




Working Conditions


A. Lifting, pushing, and/or pulling objects up to 50lbs: 2. Occasional (< 10% of the time)


B. Lifting, pushing, and/or pulling objects over 50lbs: 1. Never


C. Standing or walking with objects up to 10lbs: 3. Intermittent (10% - 50% of the time)


D. Standing or walking with objects up to 25lbs: 2. Occasional (< 10% of the time)


E. Sitting at computer workstation for extended periods: 4. Regular (> 50% of the time)


F. Risk of back injury from moving, lifting or positioning patients, equipment, or materials: 1. Never


G. Repetitive motion: 4. Regular (> 50% of the time)


H. Working at heights above 4 feet: 1. Never


I. Working in confined spaces: 1. Never


J. Risk of injuries from use of equipment on the job: 1. Never


K. Job-related travel: 2. Occasional (< 10% of the time)


L. Loud noises: 1. Never


M. Temperature extremes: 1. Never


N. Hazardous chemicals and fumes including waste: 1. Never


O. Radiation: 1. Never


P. Burns: 1. Never


Q. Cuts/Punctures: 1. Never


R. Bloodborne/airborne pathogens: 1. Never


S. Recombinant DNA or viral vectors: 1. Never


T. Combative/violent people: 1. Never


U. Animal handling (including carcasses): 1. Never


V. Please specify other(s) and amount of exposure (i.e. Occasional, Intermittent or Regular): N/A






Physical Demands


This position requires regular sitting at a computer workstation for extended periods of time; performing tasks with repetitive motions (such as typing); intermittent standing or walking with objects weighing up to 10 pounds; and occasional lifting, pushing, and/or pulling of objects weighing up to 50 pounds. Occasional job-related travel may also be required.




Additional Job Descriptions


N/A

Department:

KDIP Oncology Portsmouth

Shift:

Days (United States of America)

Time Type:

Full time

Address:

916 11th Street

City, State:

Portsmouth, Ohio
Original job Reimbursement Coordinator Associate posted on GrabJobs ©. To flag any issues with this job please use the Report Job button on GrabJobs.
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