Highlights
With a focus on meeting the needs of our patients at all access points, Physician Services is dedicated to implementing innovative, physician-driven, value-added solutions to assist physicians in providing high-quality, patient-centered care, aligning with our mission to care for and enhance human life. Supporting HCA Healthcare's 186 hospitals and 2,400+ sites of care, Physician Services plays a crucial role as the main entry point for patients looking for high-quality healthcare within the HCA Healthcare system.
Numbers & Facts
| Location | Nashville, TN |
| Industry | Healthcare Services |
| Company Size | 10,000 employees or more |
| Year Founded | 1968 |
| Website | http://hcahealthcare.com/ |
Description
Experience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career with an organization committed to delivering respectful, compassionate care, and where the unique and intrinsic worth of each individual is recognized. Submit your application for the opportunity below: Authorization Coordinator WFH
***Must reside in San Antonio***
Job Summary and Qualifications
The Authorization Coordinator is responsible for timely and accurate processes associated with some or all of the following job duties; pre-certification, obtaining and certifying authorizations, assisting with appeals of authorizations. Additionally, collaborates with the referral coordinator to ensure that all approvals are obtained.
What you will do in this role:
Responsible for review and completion of prior authorizations to ensure timeliness of appointments, testing, procedures, and claims filing.
Obtain clinical information (including but not limited to medical history, diagnosis, and any relevant lab reports) necessary to complete the Prior Authorization to include insurance requirements.
Follow the criteria for all services requiring prior authorizations and submit requests in a timely manner. Ensure appropriate documentation is entered into the standard billing system. Ensuring that this documentation entry is performed in all needed systems.
Tracks status of prior authorizations via payor authorization portals
Reviews denied claims for clinical accuracy, corrects errors for claims resubmission.
Clearly support patient experience through patient-centered communications demonstrating excellent customer service skills
Communicate with insurance companies to pre-certify/authorize/amend services
Recommend new approaches, policies, and procedures to influence continuous improvements in department's efficiency and services performed
Actively participate in problem identification and coordinates resolution between appropriate parties
Utilize appropriate communication system to facilitate communication with hospital partners
Ensure appropriate documentation is entered in standard format in billing system. This should be performed in the applicable Health Information System (i.e. Source systems) and if necessary, any other subsidiary systems if they are not automatically updated. – Is this redundant from bullet three? Could probably combine this one and bullet three into one statement.
Research Patient Visit History to ensure compliance with payor specific payment window rules; appropriately communicate patient payment responsibilities and guide them through needed steps.
Performs other related job functions as assigned
Practice and adhere to the Code of Conduct and Mission, and Value Statements.
What Qualifications you will need:
EDUCATION:
High School Diploma or GED equivalent required
EXPERIENCE:
One year of related experience with medical insurance plans and/or Medicare benefits verification required.
One-year medical clinic, urgent care, or hospital care setting experience preferred
Prior Authorization experience preferred
CERTIFICATION/LICENSE:
None required
Benefits
The Authorization Coordinator is responsible for timely and accurate processes associated with some or all of the following job duties; pre-certification, obtaining and certifying authorizations, assisting with appeals of authorizations. Additionally, collaborates with the referral coordinator to ensure that all approvals are obtained.
What you will do in this role:
Responsible for review and completion of prior authorizations to ensure timeliness of appointments, testing, procedures, and claims filing.
Obtain clinical information (including but not limited to medical history, diagnosis, and any relevant lab reports) necessary to complete the Prior Authorization to include insurance requirements.
Follow the criteria for all services requiring prior authorizations and submit requests in a timely manner. Ensure appropriate documentation is entered into the standard billing system. Ensuring that this documentation entry is performed in all needed systems.
Tracks status of prior authorizations via payor authorization portals
Reviews denied claims for clinical accuracy, corrects errors for claims resubmission.
Clearly support patient experience through patient-centered communications demonstrating excellent customer service skills
Communicate with insurance companies to pre-certify/authorize/amend services
Recommend new approaches, policies, and procedures to influence continuous improvements in department's efficiency and services performed
Actively participate in problem identification and coordinates resolution between appropriate parties
Utilize appropriate communication system to facilitate communication with hospital partners
Ensure appropriate documentation is entered in standard format in billing system. This should be performed in the applicable Health Information System (i.e. Source systems) and if necessary, any other subsidiary systems if they are not automatically updated. – Is this redundant from bullet three? Could probably combine this one and bullet three into one statement.
Research Patient Visit History to ensure compliance with payor specific payment window rules; appropriately communicate patient payment responsibilities and guide them through needed steps.
Performs other related job functions as assigned
Practice and adhere to the Code of Conduct and Mission, and Value Statements.
What Qualifications you will need:
EDUCATION:
High School Diploma or GED equivalent required
EXPERIENCE:
One year of related experience with medical insurance plans and/or Medicare benefits verification required.
One-year medical clinic, urgent care, or hospital care setting experience preferred
Prior Authorization experience preferred
CERTIFICATION/LICENSE:
None required
Work from Home, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:
- Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services
- Wellbeing support, including free counseling and referral services
- Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence
- Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling
- Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing
- Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts
Learn more about Employee Benefits
Note: Eligibility for benefits may vary by location.
Supporting HCA Healthcare's 186 hospitals and 2,400+ sites of care, Physician Services plays a crucial role as the main entry point for patients looking for high-quality healthcare within the HCA Healthcare system. With a focus on meeting the needs of our patients at all access points, Physician Services is dedicated to implementing innovative, physician-driven, value-added solutions to assist physicians in providing high-quality, patient-centered care, aligning with our mission to care for and enhance human life.
HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in costs for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.
"There is so much good to do in the world and so many different ways to do it."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder
If you find this opportunity compelling, we encourage you to apply for our Authorization Coordinator WFH opening. We promptly review all applications. Highly qualified candidates will be directly contacted by a member of our team. We are interviewing - apply today!
We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
About Company
At its founding in 1968, Nashville-based HCA was one of the nation's first hospital companies. Today, we are the nation's leading provider of healthcare services, a company comprised of locally managed facilities that includes about 165 hospitals and 115 freestanding surgery centers in 20 states and England and employing approximately 204,000 people. Approximately four to five percent of all inpatient care delivered in the country today is provided by HCA facilities. Richard M. Bracken serves as Chairman of HCA and R. Milton Johnson is the company's President and Chief Executive Officer.
HCA is committed to the care and improvement of human life and strives to deliver high quality, cost effective healthcare in the communities we serve. Building on the foundation provided by our Mission & Values, HCA puts patients first and works to constantly improve the care we give them by implementing measures that support our caregivers, help ensure patient safety and provide the highest possible quality. Investing in our communities is important to us. HCA typically invests about $1.5 billion annually to keep our facilities modern and up-to-date technologically and to expand and add services where needed. Focusing primarily on communities where the company is a leading healthcare provider, HCA selectively adds new facilities in order to better serve our communities.
And because two HCA founders were physicians, we value highly the strong relationships we've created with local physicians. We endeavor to provide them with a wide array of services and modern facilities in order to help them deliver the best possible care.