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Overview

Coordinator-Authorization

Job Code: 22772

FLSA Status

Job Family: CASE MGMT

Job Description Title: Coordinator-Authorization

Job Summary

The Authorization Coordinator is responsible for facilitating information documentation and transmission vital to the effectiveness of utilization review and supporting Baptist’s reimbursement strategy. Specifically the managed care techniques the Coordinator uses focuses on prior authorization for services using evidence based criteria. Areas of work include payer notification, authorization management, denial management, escalations, and communication and coordination between payer, business office and UR Team

Job Responsibilities

+ Completes payer notification

+ Communicates incorrect payer with patient access

+ Communicate with Utilization Review Nurse

+ Works assigned queues in the electronic medical record

+ Documents next review dates in the electronic medical record

+ Documents and updates authorized or denied information on auth/cert screen in the electronic medical record

+ Schedules peer to peer when indicated

+ Completes assigned goals

Specifications Experience Description Minimum Required Preferred/Desired 2 years’ clerical/support experience in a medical environment Previous authorization coordinator experience

Education Description Minimum Required Preferred/Desired High School Degree or equivalent Bachelor’s degree

Training Description Minimum Required Preferred/Desired

Special Skills Description Minimum Required Preferred/Desired Solid intermediate computer skills, Microsoft Office Suite; Knowledge of medical terminology and insurance; Accurate data entry

Licensure Description Minimum Required Preferred/Desired

Reporting Relationships

Does this position formally supervise employees? If set to YES, then this position has the authority (delegated) to hire, terminate, discipline, promote or effectively recommend such to manager. Reporting Relationships No

Work Environment Functional Demands Label Short Description Full Description Sedentary Very light energy level Lift 10lbs. box overhead. Lift and carry 15lbs. Push/pull 20lbs. cart Light Moderate energy level Lift and carry 25-35lbs. Push/pull 50-100lbs. (ie. empty bed, stretcher) Medium High energy level Lift and carry 40-50lbs. Push/pull +/- 150-200lbs. (Patient on bed, stretcher) Lateral transfer 150-200lbs. (ie. Patient) Heavy Very high energy level Lift over 50lbs. Carry 80lbs. a distance of 30 feet. Push/pull > 200lbs. (ie. Patient on bed, stretcher). Lateral transfer or max assist sit to stand transfer.

Functional Demands Rating Sedentary

Activity Level Throughout Workday Physical Activity Requirements - Sitting Occasional

Physical Activity Requirements - Standing Occasional

Physical Activity Requirements - Walking Occasional

Physical Activity Requirements - Climbing (e.g., stairs or ladders) Occasional

Physical Activity Requirements - Carry objects Occasional

Physical Activity Requirements - Push/Pull Occasional

Physical Activity Requirements - Twisting Occasional

Physical Activity Requirements - Bending Occasional

Physical Activity Requirements - Reaching Forward Occasional

Physical Activity Requirements - Reaching Overhead Occasional

Physical Activity Requirements - Squat/Kneel/Crawl Occasional

Physical Activity Requirements - Wrist position deviation Occasional

Physical Activity Requirements - Pinching/fine motor activities Occasional

Physical Activity Requirements - Keyboard use/repetitive motion Occasional

Physical Activity Requirements - Taste or smell

Physical Activity Requirements - Talk or hear Continuous

Sensory Requirements Color Discrimination Near Vision Far Vision Depth Perception Hearing Yes Accurate Accurate Minimal Minimal

Environmental Requirements - Blood-Borne Pathogens Anticipated

Environmental Requirements - Chemical Anticipated

Environmental Requirements - Airborne Communicable Diseases Anticipated

Environmental Requirements - Extreme Temperatures Anticipated

Environmental Requirements - Radiation Anticipated

Environmental Requirements - Uneven Surfaces or Elevations Anticipated

Environmental Requirements - Extreme Noise Levels Anticipated

Environmental Requirements - Dust/Particular Matter Anticipated

Environmental Requirements - Other

REQNUMBER: 30992