Authorization Coordinator Edinburg ENT

Please review the job information below.

About Driscoll

• Where compassion meets innovation and technology and our employees are family.
• Thank you for your interest in joining our team!

Responsibilities

• Using the EPIC EMR system, individual will be responsible for working with surgical staff and patients family to schedule surgeries.
• Verifies insurance hospital coverage for all patients and obtains authorizations needed for all surgeries for both inpatient and outpatient benefits.
• Individual also will have to ensure all surgical clearances needed prior to surgery including cardiac, neurological and pulmonology are obtained.
• Will act’s as primary liaison between Driscoll Children’s Hospital’s operating room, physicians and/or their designees regarding the scheduling of all surgical procedures.
• Ensures fair and even administration of the rules regarding the scheduling of elective surgical procedures.
• Also works as liaison between families hospital financial coordinator when families do not have insurance for patients who urgently need surgery.
• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
• This job description is not intended to be all-inclusive; employees will perform other reasonably related business duties as assigned by the immediate supervisor and/or hospital administration as required. • Maintains utmost level of confidentiality at all times. • Adheres to hospital policies and procedures. • Calls insurance companies for pre-certifications requirements. • Obtains prior authorizations for both in-patient and out-patient services for all patient cases. • Ensures that patients that require surgical clearances are obtain prior to the scheduled surgery. • Ensure that all medications that need prior authorization are done and ready for the patients surgery • Coordinates and works with DME companies for wound care vac’s which require authorization. • Ensure that home health is coordinated prior to patient discharge. • For kidney transplant patients, it is necessary to ensure that all labs and ancillary services are coordinated for a successful surgery. • Coordinates schedules with outside vendors that support the physicians including ENT and Urology for any surgeries that require such services. • Coordinates surgeries with other surgeons including
• Plastic, Neurology and Pulmonology for patients that require multiple services. • Demonstrates business practices and personal actions that are ethical and adhere to corporate compliance and integrity guidelines. • Inputs appropriate data necessary for proper and accurate scheduling of elective surgical procedures. • Ensures thorough schedule management that optimizes utilization of elective surgical time and surgical equipment. • Maintains and updates the EPIC surgical scheduling system . • Troubleshoots problems with scheduling system and identifies / implements corrective actions. • Obtains consent signatures of parents/guardians for hospital surgical consents.

Requirements

• --- High school diploma or general education degree (GED); and two to three years related experience and/or training in medical field; or equivalent combination of education and experience. --- Experience with ICD 10 and CPT coding --- Strong knowledge of clinical/medical practice operations, procedures, terminology, and administrative procedures

The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.