VNS Health Hiring for Authorization Coordinator at Manhattan, NY Full Time

Completes data input for authorization/service requests. Works collaboratively with other departments to troubleshoot and resolve authorization related issues in a timely and efficient manner. Ensures timely and effective delivery of services. Works under general supervision.

Responsibilities
• Creates and modifies authorizations and/or orders for new and existing Members in an accurate and timely matter • Researches, troubleshoots, resolves authorization and/or order processing issues and discrepancies • Completes activities, including but not limited to, inbound/outbound calls, as assigned, faxes and emails • Obtains information from internal and external sources. Processes or triages the request via our medical management information system or external sources • Coordinates with Providers and Members regarding authorization requests and/or activities • Communicates with Care Management, Member Services, Membership and Eligibility and other internal departments regarding Member services, authorization requests and issues • Reviews all authorization requests for accuracy and prioritizing based on urgency • Documents communication, actions taken and barriers in the Medical Management System as it pertains to the Members Care or request for services • Utilizes internal and external systems to verify eligibility and Provider Information such as name, address, fax number, NPI and TAX ID. • Conducts follow-up, as necessary, to ensure member satisfaction and successful delivery of service • Protects the confidentiality of member information and adheres to company policies regarding confidentiality. • Participates in special projects and performs other duties as assigned.
Qualifications
Education:

High School Diploma or equivalent required

Work Experience:

Minimum of two years of experience in a customer service role required Excellent oral and written communication skills required Advanced personal computer skills, including Word, Excel or Access required Utilization Management experience preferred