Telehealth Prior Authorization Coordinator

Company Description

Welcome to Sedona Management Solutions, your trusted partner for cutting-edge technical solutions. We specialize in delivering innovative and tailored technical solutions to address unique business needs. Our expertise includes bespoke software development, medical billing solutions, custom web app development, and mobile app development to empower businesses in the digital age.

Job Description

We are looking for a detail-oriented and motivated Prior Authorizations Coordinator to join our team!

The ideal candidate is a quick learner, well-organized, and has a significant background in providing excellent customer service! This individual must also enjoy working with people and helping to ensure our patients are receiving timely care. In addition, the ideal candidate will have effective communication skills, – listening included – the ability to establish long-term interpersonal professional relationships.

Key Responsibilities :

Review and analyze patient medical records to determine the necessity of prior authorizations for various procedures and treatments.

Communicate effectively with healthcare providers, patients, and insurance companies to gather required information and submit authorization requests.

Maintain accurate documentation of all authorization requests, approvals, and denials in compliance with HIPAA regulations.

Follow up on pending authorizations and resolve any issues that may arise during the approval process.

Stay updated on changes in insurance policies, managed care requirements, and relevant medical coding practices (ICD-10).

Collaborate with medical office staff to ensure seamless patient care and efficient processing of authorizations.

Educate patients on the prior authorization process and any necessary steps they need to take

Sleep authorization processing for sleep studies in-lab and home sleep studies

Sleep consultations authorizations

Sleep study appeals process

Oral appliance referral process

Schedule : Monday – Friday |8am to 5pm PST

Preferred :

Outpatient practice experience

Experience with Multispecialty practice

Proficiency in EPIC EMR