Authorization and Benefits Coordinator

Gastro Health - Pensacola, FL

Full-time - Entry Level

Pensacola, FL

101-250 employees

Ambulatory Health Care Services

About the position

Gastro Health is seeking an Authorization and Benefits Coordinator to join our team! This position is integral to our operations, focusing on obtaining preauthorization for outpatient surgeries and advanced imaging procedures. The role involves insurance follow-up specific to coding denials, identifying revenue opportunities through reimbursement trending and audits, and responding to inquiries from patients, Practice Managers, and medical departments. The coordinator will also perform various related duties as requested by their direct manager. In this role, you will utilize the Managed Care Work list to track the receipt, delays, and completion of requests, prioritizing them to obtain authorizations at least one week prior to the scheduled date of service whenever possible. You will work with Eligibility and Authorization reports for the Diagnostic Center, tracking activities to identify carrier trends and making recommendations regarding these trends to the department director. Additionally, you will review and work on Denial Reports for the Diagnostic Center, ensuring that patient accounts are updated with the correct insurance information. The position requires independent assessment of carrier trends on a proactive basis, facilitating communication among parties impacted by coding-related matters to produce timely and satisfactory solutions. Staying informed of insurance requirements and industry-related news or policy changes is crucial, as is responding to patient inquiries in a courteous and professional manner. You will be expected to complete assigned reports and projects within deadlines while maintaining a positive and cooperative working relationship with both internal and external customers. This role offers a great work/life balance with no weekends or evenings, as it operates Monday through Friday. Gastro Health is a rapidly growing team with opportunities for advancement, competitive compensation, and a comprehensive benefits package.

Responsibilities

• Perform duties related to obtaining preauthorization for outpatient surgeries and advanced imaging procedures.
• Conduct insurance follow-up specific to coding denials.
• Identify revenue opportunities as a result of reimbursement trending and audits.
• Respond to questions from patients, Practice Managers, and medical departments.
• Utilize the Managed Care Work list to track receipt, delays, and completion of requests.
• Work on Eligibility and Authorization reports for the Diagnostic Center.
• Track activity to identify carrier trends and make recommendations to the department director.
• Review and work on Denial Reports for the Diagnostic Center.
• Update patient accounts with the correct insurance information.
• Independently assess carrier trends and communicate information to appropriate personnel.
• Facilitate communication among parties impacted by coding-related matters.
• Stay informed of insurance requirements and industry-related news/policy changes.
• Respond to patient inquiries in a courteous and professional manner.
• Complete assigned reports and/or projects within deadlines.
• Maintain a positive and cooperative working relationship with internal and external customers.
• Communicate professionally with staff in medical offices and co-workers.
• Follow established corporate and department-specific policies and procedures.
• Perform other duties as assigned.

Requirements

• Minimum education requirement is a high school diploma or GED.
• Minimum of 2 years experience in the healthcare insurance area.
• Display customer service skills and strong interpersonal skills.
• Close attention to detail and excellent verbal and written communication skills.
• Ability to work with staff members at all levels of the organization in a cooperative, team-oriented manner.
• Good organizational skills and the ability to adapt to frequent changes.
• Proficient in Microsoft Office and EMR software.
• Proficient in English language both in written and verbal communication.
• Ability to communicate with individuals of varying socio-economic backgrounds.
• Professional demeanor and recognition of privacy considerations for patients and families.
• Commitment to the protection of confidential information, records, and reports.

Nice-to-haves

• Experience with coding and billing processes in healthcare.
• Knowledge of insurance carrier requirements regarding pre-authorization of services.

Benefits

• 401(k) retirement plans with employer Safe Harbor Non-Elective Contributions of 3%.
• Discretionary profit-sharing contributions of up to 4%.
• Health insurance with employer contributions to HSAs and HRAs.
• Dental insurance.
• Vision insurance.
• Flexible spending accounts.
• Voluntary life insurance.
• Voluntary disability insurance.
• Accident insurance.
• Hospital indemnity insurance.
• Critical illness insurance.
• Identity theft insurance.
• Legal insurance.
• Paid time off.
• Discounts at local fitness clubs.
• Discounts at AT&T.
• Participation in a program called Tickets at Work for discounts on concerts, travel, movies, and more.