Pre-Authorization Coordinator JobDurham, North Carolina

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Why You'll Love This Job

About the Role
As the Pre-Authorization Coordinator, you will verify mental health benefits, process authorizations, and complete patient registration. This position will utilize the practice management system to enter insurance and patient demographic data as well as run reports to identify and correct errors. The Pre-Authorization Coordinator requires collaboration with various staff, insurance companies, and patients to resolve insurance issues via the telephone.

Key Responsibilities:

  • Utilize phone system, RTS (AdvancedMD) and/or insurance website portals to verify patients’ insurance benefit details
  • Obtains authorizations for outpatient mental health visits when needed
  • Registers patients using the practice management system (AdvancedMD) once coverage is confirmed
    • If insurance coverage cannot be confirmed, contacts patient/policyholder for correct   information
    • If patient does not have coverage for our services, contacts patient/policyholder to notify and explain options
  • Reference credentialing spreadsheets to verify provider participation
  • Escalate any discrepancies on the credentialing spreadsheet to supervisor for resolution
  • Coordinates with Front Office staff, Billing staff, Intake staff, and patient to resolve insurance issues and corrects registration errors within the practice management system (NextGen)
  • Sets up new cases for existing patients when their insurance plan changes, including provider or location transfers
  • Contacts patients to address any insurance and/or demographic issues
  • Provide backup coverage to incoming call queue for new patient intake if needed

Qualifications:

  • High school diploma or equivalent
  • Excellent customer service skills with previous customer service experience preferred
  • Strong attention to detail with the ability to prioritize and multi-task
  • Excellent communication skills, both written and oral
  • Basic proficiency with Microsoft Office (Outlook, Excel, and Word); multiline phone experience; accurate typing/data entry skills
  • Ability to work independently or as part of a team
  • Previous experience working in patient registration services desired

The Benefits
We offer a robust benefits package to include:

  • Medical, dental, vision, life, and long-term disability
  • Menu of voluntary plans, including pet, legal services, and accident insurance.
  • 10 paid holidays and a generous paid time off package.

About CP|MP
Community Psychiatry and MindPath Care Centers have joined together to create a clinically-driven mental health services organization. With 70+ locations nationally and more than 350 clinicians (and growing!), we are committed to increasing access to mental health services through a collaborative approach by integrating modern mental health treatments and technologies to create optimal patient experience. We provide comprehensive and individualized outpatient mental health treatment services – meeting patients where they are in their mental health journeys.

Join our community and discover how rewarding work can be!

Community Psychiatry is an equal opportunity employer. We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, ancestry, age, disability, veteran status, or any other status legally protected by federal, state or local law.

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Req ID: 1714

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