Authorization Coordinator, Full-time, Day Shift

Centered in the heart of Boyle Heights, Adventist Health White Memorial is one of the area's leading healthcare providers since 1913. We are comprised of a 353-bed hospital, three medical office buildings, residency programs, comprehensive cancer care and a vast scope of services located in the Los Angeles area. In 2019, Adventist Health White Memorial was recognized with the Malcolm Baldrige National Quality Award, the nation's highest presidential honor for performance excellence. We are proud to promote wellness in the community at the local farmers market and through our community resource center with services for seniors and Spanish-speakers. Los Angeles is known for its art, rich culture, numerous sports teams and world-renowned dining. There is something for everyone in this culturally diverse city. Job Summary: Responsible for management of prior authorizations of all activities requiring referrals for procedures, serves as the key coordinator and liaison whose primary role is to expedite the collection process. Job Requirements: Education and Work Experience: High School Education/GED or equivalent: Preferred Associate’s/Technical Degree or equivalent combination of education/related experience: Preferred Facility Specific License/Certifications: Hospital Fire and Life Safety (HLFS): Required Essential Functions: Performs daily reconciliation of scheduled procedures, documenting authorization numbers obtained by others, as well as obtaining any authorizations and retroactive authorizations as needed. Serves as the coordinator for scheduled and pre-authorized procedures. Reconciles, updates and obtains retroactive authorizations as needed. Performs insurance verification prior to office visit procedures. Interacts with providers and staff to provide guidance and advice with regard to billing, relative to necessary procedures. Serves as an authoritative source to reconcile and update the authorization numbers and generate a work list of authorizations needed. Communicates with insurance providers about the patient’s medical necessity, obtain authorization for needed authorizations and reconcile to the authorization database and/or hospital systems. Corrects inaccurate information, CPT and ICD9 codes that prohibit pre-authorization being secured and charges being entered into billing system. Performs other job-related duties as assigned. Organizational Requirements: Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply. Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.