An Authorization Coordinator is responsible for verifying coordinating benefits, patient-eligibility process and addressing patient’s concerns relating to authorization and turnaround. Typical duties that can be found highlighted in the Authorization Coordinator Resume include some or all of the following – interviewing and assisting patients with their authorization documents, monitoring and tracking authorization of patients, informing supervisors about expired dates, verifying benefits with the insurance provider to ensure correct payment for services, obtaining and reviewing insurance authorization referrals, and maintaining appropriate logs as per state or federal requirements.
The education requirement may vary based on the employer preference and job setting, but most of the candidates applying for this role have a college degree preferably with a medical coding certification or experience. Work experience in insurance and authorization will be given due weightage. Skills include demonstrating a strong communication skill, the ability to identify even the minutest mistake and close attention to details.
Objective : Dedicated Authorization Coordinator with over 2 years of experience in processing medical authorizations and ensuring compliance with healthcare regulations. Proven ability to manage referral processes, enhance patient care, and streamline administrative workflows. Committed to delivering exceptional service to healthcare providers and patients alike, while continuously improving operational efficiency.
Skills : Healthcare Data Management, Patient Advocacy, Medical Billing And Coding, Claims Processing
Description :
Managed daily processing of TRICARE referrals, providing guidance to personnel on complex cases.
Addressed escalated inquiries related to referrals and authorization letters, ensuring timely resolution.
Logged and tracked notifications and provider statuses, assessing the necessity for each.
Delivered outstanding customer service, consistently meeting productivity and quality standards.
Assisted in managing incoming faxes and emails, completing routine tasks independently.
Evaluated and recommended improvements to existing processes for enhanced efficiency.
Collaborated with providers to resolve contracting issues, ensuring proper routing to specialists.
Experience
0-2 Years
Level
Entry Level
Education
AAS
Entry Level Authorization Coordinator Resume
Objective : Motivated professional with 2 years of experience in medical authorization processes and patient support. Skilled in navigating insurance systems, enhancing patient communication, and ensuring compliance with healthcare regulations. Eager to contribute to operational efficiency and assist healthcare providers, while delivering high-quality service to patients.
Skills : Medical Software Proficiency, Regulatory Compliance, Prior Authorization, Communication Skills, Attention To Detail
Description :
Facilitated patient authorization processes for medical services and procedures.
Retrieving approvals and denials for submitted requests, ensuring timely communication with patients.
Reviewed and verified insurance eligibility for patients seeking treatment.
Notifying patients via telephone of approval or denials, providing location information for scheduling physical therapy, occupational therapy, and imaging services.
Scheduling patient appointments for in-house authorizations and follow-ups with physicians, ensuring accurate CPT coding for insurance coverage.
Developing and maintaining cooperative working relationships with health plans, medical groups, and insurance providers.
Managing patient inquiries regarding referral status and the authorization process in a courteous and professional manner.
Experience
0-2 Years
Level
Entry Level
Education
AAS in MOA
Authorization Coordinator Resume
Headline : Seasoned Authorization Coordinator with 7 years of experience in managing comprehensive medical authorization processes and ensuring adherence to healthcare regulations. Adept at optimizing workflows, enhancing patient care, and fostering strong relationships with healthcare providers. Passionate about improving operational efficiency and delivering superior support to patients and providers alike.
Obtained prior authorizations for new and established patients, ensuring compliance with insurance protocols.
Managed upgrades and downgrades of prior authorizations based on radiologist requests to optimize patient care.
Responded efficiently to priority issues, ensuring timely care for urgent patient needs.
Served as the primary contact for over 20 physicians in a large radiology facility, nurturing professional relationships.
Conducted timely verification of medical insurance benefits, facilitating seamless patient service.
Assisted patients in resolving COB issues, clarifying account information, charges, and related inquiries.
Developed and maintained comprehensive documentation to support authorization processes and ensure compliance.
Experience
5-7 Years
Level
Senior
Education
B.S. Health Admin.
Verification Authorization Coordinator
Resume
Objective : With 5 years of experience in verification and authorization, I excel in processing medical authorizations while ensuring compliance with industry regulations. My expertise includes managing patient referrals, optimizing workflows, and enhancing communication between healthcare providers and insurers. I am dedicated to improving operational efficiency and delivering exceptional support to both patients and providers.
Collaborated with healthcare professionals to ensure timely processing of authorizations.
Facilitated Peer-to-Peer discussions between providers and insurance representatives.
Created and managed authorization documentation through electronic systems and hard copies.
Investigated and resolved issues related to approval, deferral, and denial of services.
Reviewed denial letters and resubmitted authorizations based on insurance requirements.
Maintained accurate records in compliance with healthcare regulations.
Prioritized workload to ensure all authorizations were processed within deadlines.
Experience
2-5 Years
Level
Management
Education
B.S. Health Admin.
Authorization Coordinator Resume
Objective : Dynamic professional with 2 years of experience in facilitating medical authorizations and ensuring adherence to healthcare compliance standards. Skilled in managing referral processes, improving patient engagement, and optimizing administrative workflows. Passionate about providing exceptional support to healthcare providers and enhancing patient experiences through efficient operations.
Skills : Proficient In Microsoft Office Suite 2010/2013, Data Entry And Management, Healthcare Knowledge, Electronic Health Records, Scheduling Appointments, Conflict Resolution
Description :
Receive and process referral requests from healthcare providers efficiently.
Ensure authorization requests align with UM Departmental Policies and client-specific procedures.
Forward referral requests for further review, maintaining a clear communication channel.
Coordinate outpatient surgical procedures with health plan authorization departments as needed.
Update patient demographics and follow up on referral statuses to ensure continuity of care.
Verify insurance coverage and eligibility for medical services.
Document and maintain accurate case notes for all authorization requests.
Experience
0-2 Years
Level
Junior
Education
BSHA
Authorization Coordinator II Resume
Headline : Accomplished Authorization Coordinator with 7 years of experience in overseeing medical authorization processes and ensuring compliance with healthcare standards. Expertise in managing referral workflows, enhancing patient interactions, and collaborating with healthcare providers for optimal service delivery. Committed to driving operational excellence and improving patient outcomes through effective authorization management.
Skills : Training And Development, Resource Management, Database Management, Patient Education
Description :
Facilitated physician referrals, obtaining necessary authorizations and pre-certifications for both new and established patients.
Conducted thorough insurance verifications for inpatient and outpatient services, ensuring compliance with coverage requirements.
Reviewed patient account balances and documented payment requirements for coding specialists and front desk staff.
Ensured accurate entry of patient insurance details to facilitate billing processes.
Confirmed that patients had appropriate authorizations and met all insurance criteria before service delivery.
Collaborated with healthcare providers to ensure seamless referral and authorization processes.
Utilized data analytics to monitor authorization timelines and identify areas for improvement.
Experience
5-7 Years
Level
Senior
Education
B.S. Health Admin.
Authorization Coordinator Resume
Objective : Driven Authorization Coordinator with 5 years of expertise in managing medical authorizations and ensuring regulatory compliance. Skilled in facilitating patient referrals, enhancing communication between providers and insurers, and optimizing administrative processes. Dedicated to improving patient outcomes and operational efficiency through effective authorization management and exceptional service.
Skills : Healthcare Compliance, Authorization Processing, Problem Solving, Insurance Verification, Time Management, Team Collaboration
Description :
Conduct financial counseling with patients prior to admission, detailing financial obligations and billing practices.
Collect applicable deductibles, copayments, and coinsurance upfront through various payment methods.
Perform insurance verifications and secure initial and subsequent pre-authorization for medical services.
Generate reports to assess patient eligibility for insurance coverage.
Cross-train in Intake to manage referrals effectively and streamline processes.
Coordinate scheduling and staffing with appropriate personnel, ensuring timely patient care.
Establish payment responsibilities for office visits and procedures, including private pay options.
Experience
2-5 Years
Level
Consultant
Education
B.S. Health Admin.
Assistant Authorization Coordinator Resume
Objective : Enthusiastic Assistant Authorization Coordinator with 2 years of experience in managing medical authorizations and ensuring regulatory compliance. Skilled in coordinating patient referrals and enhancing communication with healthcare providers. Focused on optimizing workflows to improve operational efficiency and deliver high-quality support to both patients and providers.
Verified eligibility and benefits for new patients, ensuring accurate service initiation.
Managed ongoing authorizations for patients, maintaining compliance and continuity of care.
Responded to patient inquiries, resolving billing and authorization questions effectively.
Facilitated communication between patients and providers to streamline service delivery.
Conducted thorough evaluations of insurance information for patients.
Coordinated approved services with healthcare providers and discharge planners.
Maintained detailed records of patient authorizations and insurance communications.
Experience
0-2 Years
Level
Entry Level
Education
AAS in HIT
Authorization Coordinator Resume
Summary : Detail-oriented Authorization Coordinator with over 5 years of experience in managing patient authorizations and insurance verification processes. Proven track record of improving authorization turnaround times and enhancing patient satisfaction. Strong communication skills and adept at collaborating with healthcare providers and insurance companies to ensure compliance and streamline operations.
Skills : Medical Coding, Negotiation Skills, Adaptability, Empathy, Organizational Skills, Research Skills
Description :
Conduct outbound calls to medical offices and insurance companies to verify patient prescriptions and treatment eligibility.
Manage inbound calls regarding authorization inquiries, denials, and treatment expirations.
Coordinate the delivery of treatments and medications based on patient eligibility.
Ensure the confidentiality of patient medical records and insurance information.
Address patient inquiries and provide clarifications regarding medications and treatment schedules.
Interface directly with diverse patient populations, responding to inquiries and concerns effectively.
Document all interactions and maintain accurate records for compliance and reporting purposes.
Experience
7-10 Years
Level
Management
Education
BSN
Authorization Coordinator III Resume
Objective : Dedicated Authorization Coordinator skilled in navigating complex insurance systems and ensuring compliance with healthcare regulations. Expertise in processing prior authorizations, verifying patient eligibility, and maintaining accurate records. Committed to enhancing patient experiences through effective communication and problem-solving in fast-paced environments.
Skills : Multi-tasking, Documentation Skills, Outlook Email Management, Healthcare Customer Service
Description :
Processed and composed medical authorizations from telephonic and faxed requests from healthcare providers.
Ensured accurate completion of authorization screens and monitored the status of requests.
Collaborated with clinical staff on complex coverage issues requiring additional review.
Conducted follow-ups to clarify requests and improve communication.
Requested clinical information for authorizations requiring in-depth review.
Educated providers on Plan policies, procedures, and benefits.
Interacted with patients to collect insurance details, discuss benefits, and coordinate appointments.
Experience
2-5 Years
Level
Management
Education
B.S. Health Admin.
Authorization Coordinator Resume
Headline : Proficient Authorization Coordinator with 7 years of extensive experience in managing medical authorizations and ensuring regulatory compliance. Demonstrated success in optimizing workflows, enhancing patient care, and collaborating effectively with healthcare providers. Driven to improve operational efficiencies and deliver exceptional service to both patients and providers.
Skills : Training And Mentoring, Risk Assessment, Project Management, Statistical Analysis, Analytical Skills
Description :
Coordinated authorization requests for surgeries, rehabilitation, consultations, and follow-ups.
Gathered necessary information from providers to facilitate authorization processing.
Collaborated with nurses and medical directors to finalize authorization requests.
Performed data entry for patient and provider information, along with claims processing for capitated services.
Maintained accurate records of authorization requests and outcomes.
Collaborated with clinical staff to ensure compliance with insurance policies.
Supported the Utilization Management team with research and follow-up on prior authorizations.
Experience
5-7 Years
Level
Management
Education
B.S. in HCA
Authorization Coordinator Resume
Objective : Experienced Authorization Coordinator with 2 years in medical authorization and insurance verification. Proven track record in managing referral processes, ensuring regulatory compliance, and enhancing patient communication. Adept at streamlining workflows to improve operational efficiency while providing exceptional support to both patients and healthcare providers.
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