Authorization Coordinator Kalamazoo, MI - Position Summary The Authorization Coordinator is a part of the Financial Clearance Center (FCC), the starting gate for the patient hospital experience. Authorization Coordinators are members of a strong team in a dynamic, client focused, fast paced department. The primary focus for this role is to mitigate the financial risks to our hospital clients. The Authorization Coordinator is responsible for creating required insurance authorizations on behalf of the responsible physicians office for scheduled patients. Direct patient contact may be required to secure patients information such as demographics and insurance information, which is needed to determine patients eligibility, coverage, and authorization requirements. Authorization Coordinators will understand payer requirements and have the ability to read and understand clinical information to support the patients need for care. Success in this role is measured with the use of weekly productivity scorecards. Hard work, exemplary performance and continuously expanding knowledge base can lead to opportunities to move up and become a great people leader at R1. Reports directly to a Regional Operations Lead and receives daily ongoing support from their direct Supervisor. Your day to day role will include: - Initiates contact with client hospital patients via telephone using appropriate scripting to ensure the patients medical record is current with details such as demographics and insurance information, as needed. - Initiates contact with insurance companies via website, fax, or telephone using appropriate scripting to ensure the required level of benefit and pre-certification/authorization requirements are obtained. - Communicates with other departments as needed for order accuracy and completion. - Utilizes hospital EMR systems to obtain clinical information. - Creates timely insurance authorizations on behalf of the responsible physician office. - Effectively coordinates Peer to Peer discussions between Clinicians and Insurance companies - Provides superior customer service to all patients, works through patient-raised issues, and recommends appropriate solutions - Maintains organized, detailed summaries of prior authorization requests to support post-claim denial workflows - Complete appropriate electronic forms with detailed benefit and authorization information to ensure a clean claim. - Identifies inaccurate plan codes and corrects in the hospitals main frame. - Adheres to the guidelines set forth in the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI). You Have: - High School diploma or equivalent - At least one (1) year of experience in authorization field - Excellent customer service skills exhibiting good oral and written communication skills - Ability to type fast and accurately - Must be able to communicate effectively and professionally to our patients and physician offices. - Working knowledge of medical terminology, abbreviations and anatomy - Advanced knowledge of Health Insurance guidelines - Basic Microsoft Word and Excel - Ability to multitask and prioritize - Must be self-motivated It would be great if you also have: - Coding/Billing experience We offer: R1 is changing healthcare by infusing operational discipline and proprietary technology in hospital financial processes. We are an industry leader; we are the only independent organization with a comprehensive service and technology offering for hospital revenue cycle management, and we have achieved leading outcomes for our customers. - A strong financial performing, growing organization that will keep you on your toes with new ideas, changes and opportunities to learn and grow in abundance. - A culture of excellence, driving customer success so they can focus on improving patient care and on giving back to the community.