Authorization Coordinator - Centennial, CO

Compensation:  $21 to $24 per hour

Nexus HR is looking for an exceptional and meticulous Authorization Coordinator for a reputable immunology clinic in Colorado. The ideal candidate will have a solid understanding of accounting and financial processes and laws and good computer and verbal and written communication skills.

About the Job

The Authorization Coordinator is directly responsible for assisting with care coordination for all patients. As the first point of contact for all new patients; the care coordinator directly controls the patient experience by assisting patients through the intake, insurance authorization, provider care requirements, and coordinating, and scheduling of the first appointments. In conjunction with the patient engagement team, medical staff, and billing support, the patient coordinator will navigate and resolve any issues that would prevent new patients from obtaining care on time.  

Duties and Responsibilities:

• Communicate regularly with patients who are starting new therapies, including but not limited to infusion services and biologic injections.
• Provide the patient with a welcome call when a new therapy is ordered. 
• The patient should be informed of the following: 
  • General timeline and process for starting a new therapy and what the next steps will be. 
  • Provide the patient with any support resources, copay assistance programs, etc. that are applicable to their therapy.  
• Obtain any medical records or additional clinical items to complete the authorization checklist.  
• Communicate with the clinical team to confirm any missing items or needs before the order is submitted to insurance.
• Coordinate peer-to-peer appointments or appeals as needed.  
• Monitor daily open and pending orders.
• Communicate with the patient, clinical team, and authorization team to help streamline the order process and decrease the time from when the order is submitted to the patient starting therapy.  
• Run weekly and monthly reports monitoring patients who have stopped or paused therapies. Provide support to help restart therapy or coordinate the next steps.  
• Coordinate scheduling new appointments once therapies have been approved or direct patients to the appropriate individuals to help schedule appointments.
• Schedule follow-up appointments for therapies that have been denied. Communicate with the patient regarding next steps and/or alternative options.  
• Coordinates information and care requirements with providers; resolves issues that could affect smooth care progression; fosters support.
• Oversees copay assistance/enrolls patients.
  • Establishes rapport with the patient and provides routine updates on the status of referral/order.
  • Serves as a patient advocate and takes necessary steps to ensure patient treatment is not delayed.
  • Collaborates and supports authorization teams by obtaining information and maintaining regular communication regarding referral/order status. 
  • Maintains notes in all necessary platforms regarding the progress and status of patient’s referral/order.
• Reviews the physician care plan/order and facilitates meeting those objectives.
• Contribute to continuous process improvement by taking an active role in patient experience and satisfaction. 
• Respect patients by recognizing their rights; and maintaining their confidentiality. 
• Maintains quality service by establishing and enforcing organization standards.
• Up to date with technical knowledge and government local health plan requirements and regulations. 
• Counsels patients by providing first-time infusion planning and support. 
• Understands provider-to-patient flow to assist physicians and nurses in maintaining an efficient, productive office 
• Participates in all work-related activities that contribute to the clinic’s needs.
• Develop and maintain precise communication, manage knowledge, mitigate error, and support decision-making 
• Adhere to all policies, procedures, and regulations as outlined in the Policy and  Procedure Manual, OSHA, HIPAA, and Code of Conduct. 

Qualifications:

• At least 2 (two) years of medical authorization experience is required 
• Exceptional analytical skills are necessary to perform various data analysis techniques, and review statistical data for departmental planning and control, in the preparation and maintenance of budgets and problem-solving.
• Must possess interpersonal and communication skills (both oral and written) to provide effective participative leadership and to interact with patients, families, physicians, and other visitors and staff.
• Strong problem-solving skills.
• Proficiency with Microsoft applications.
• Proficient in current healthcare technologies including health charting software and equipment.
• Able to work on-site in Centennial, CO