Authorization Coordinator

Job not on LinkedIn

🔥 3 minutes ago

⚔️ Virginia – Remote

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⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 10%

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Logo of Sentara Health

Sentara Health

10,000+ employees

Founded 1890

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

Sentara Health is a leading healthcare system that operates over 300 sites of care in Virginia and northeastern North Carolina, including 12 acute care hospitals. The company is dedicated to providing exceptional patient care, fostering professional development, and maintaining a diverse workforce. Sentara Health aims to improve health every day and has been recognized for its clinical and operational performance, being named one of the top 15 health systems by IBM Watson Health. The organization supports its employees in achieving their full potential and encourages growth and innovation in the healthcare sector.

📋 Description

• Review clinical information received from physicians and other clinical providers • Ensure clinical data is substantial enough to authorize services • Analyze clinical information to ensure requested services are authorized according to clinical protocols • Validate member benefits for requested services • Validate insurance enrollment information in the system before authorizing services • Enter appropriate and accurate information into the claims system for payment processing

🎯 Requirements

• High School Diploma (required) • Licensed Practical Nurse – LPN (required) • 3 years of related experience (required) • Related clinical experience as an LPN, such as experience in a physician office, acute care, managed care or clinic setting • Knowledge of managed care contracting, clinical protocols and clinical review requirements • Knowledge of regulatory and compliance requirements for government payers, self-funded and commercial payers • Utilization Management experience (preferred) • Diagnostic Imaging experience (preferred) • Microsoft Suite (Word, Excel, Outlook) (preferred) • Milliman experience (preferred)

🏖️ Benefits

• Medical, Dental, Vision plans • Adoption, Fertility and Surrogacy Reimbursement up to $10,000 • Paid Time Off and Sick Leave • Paid Parental & Family Caregiver Leave • Emergency Backup Care • Long-Term, Short-Term Disability, and Critical Illness plans • Life Insurance • 401k/403B with Employer Match • Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education • Student Debt Pay Down – $10,000 • Pet Insurance • Legal Resources Plan • Opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met

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