Job TitleAuthorization Coordinator
In this role, you have the opportunity to
The Authorization Coordinator is responsible for following up on prior authorization, pre-determination and appeal receipts and decisions; reviewing, documenting, and routing decisions to appropriate department; and maintaining follow up on required appeal documents and submitted appeal requests.
You are responsible for
- Responsible for communicating approval and billing information to the Insurance Specialist and/or Appeals Specialist and Territory Manager based on departmental policy and procedure.
- Responsible for communicating denial receipt, appeal options, and ongoing appeal status to the customer, healthcare team, territory manager and/or supervisor, based on departmental policy and procedure.
- Ensure tasks are performed accurately, efficiently and timely to meet departmental and insurance payor guidelines.
- Coordinate with internal and external teams/customers to obtain all information or assistance needed to effectively process an authorization.
- Responsible for follow-up on all appeal and authorization submissions in the manner and time frame required by department policy and/or the insurance payer
- Handle incoming and outgoing calls from internal team members, insurance payers and customers related to the authorization/appeal process
- Develop and maintain working knowledge of current durable medical equipment (DME) products offered by the company and all applicable insurance guidelines as it relates to eligibility for coverage, appeal protocol and reimbursement
- Collaborate with external and internal team members and customers to create a remarkable experience for our customers, maximize reimbursement and business opportunities
- Cross train within the department to ensure smooth work flow and functional coverage
- Report recurring payer issues, trends, or changes to supervisor
- Participate in department meetings
- Attends HIPAA training and other training sessions as required
- Understand and comply with all applicable company policies and procedures
- Comply with all applicable local/state/federal regulations related to the medical device and durable medical equipment industries
- Perform other related duties as directed by supervisor
You are a part of
Insurance Team – RespirTech
To succeed in this role, you should have the following skills and experience
- Associate’s degree or higher in business or healthcare related field or equivalent work experience
- Demonstrated superior customer service skills
- Excellent communication skills, both verbal and written
- Strong analytical and problem solving skills
- Ability to organize and prioritize workload
- Ability to work independently and as part of a team
- Strong computer skills, including word processing and spreadsheet software
The role will initially be based in our Roseville office. This is a very exciting time to be joining Philips as in May 2019 we will be relocating to a facility in Plymouth, Minnesota that will become Phillips’ newest Center of Excellence.
In return, we offer you
Sharpen your talents with new challenges in our dynamic organization. As a market-driven company, we’re used to listening to our customers & apply the same thinking to our employees. We offer a competitive salary, outstanding benefits and flexibility in a career with a positive and supportive atmosphere in which to develop your talents further.
Why should you join Philips?
Working at Philips is more than a job. It’s a calling to create a healthier society through meaningful work, focused on improving 3 billion lives a year by delivering innovative solutions across the health continuum. Our people experience a variety of unexpected moments when their lives and careers come together in meaningful ways.
To find out more about what it’s like working for Philips at a personal level, visit the Working at Philips page on our career website, where you can read stories from our employee blog. Once there, you can also learn about our recruitment process, or find answers to some of the frequently asked questions.
It is the policy of Philips to provide equal employment and advancement opportunities to all colleagues and applicants for employment without regard to age, color, citizenship, disability or perceived disability, ethnicity, gender, gender identity or expression, genetic information, marital or domestic partner status, military or veteran status, national origin, pregnancy/childbirth, race, religion, sexual orientation, or any other category protected by federal, state and/or local laws. Philips is an equal employment opportunity and affirmative action employer Disability/Veteran.
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