Rehab Services Prior Authorization Coordinator

This job was posted by https://www.kansasworks.com : For more information, please see: https://www.kansasworks.com/jobs/13685708 Rehabilitation services ### Department: Rehabilitation Services ### Description: Job Summary:\ Coordinates insurance prior authorizations and case management activities for rehab services to ensure timely approval and continuity of patient care. Works closely with patients, providers, clinical staff, insurance carriers, and case managers to verify benefits, submit and monitor authorization requests, resolve denials, and maintain accurate documentation. Provides excellent customer service while supporting efficient scheduling, billing, and administrative processes. Key Responsibilities: - Review patient records, insurance policies, and provider requests to determine prior authorization requirements. - Prepare, submit, and track authorization requests for rehab services and monitor approved visits and coverage limits. - Verify insurance eligibility, benefits, coverage limitations, and authorization requirements. - Communicate with insurance representatives, providers, patients, and case managers to obtain necessary documentation and clarify coverage. - Maintain accurate authorization, denial, and case management documentation in the EHR. - Assist with denial management by researching discrepancies and coordinating with providers, payers, and the Business Office. - Coordinate workers compensation case management, including communication with case managers and submission of required progress notes and documentation. - Assist patients with insurance questions, account inquiries, and the prior authorization process. - Maintain communication with case managers and case workers throughout the patients course of therapy. - Assist with scheduling, billing-related tasks, documentation requests, and other clerical duties as needed. - Prepare reports and monitor authorization trends, scheduling outcomes, and payer information to support department operations. - Stay current with insurance requirements, payer policies, and regulations affecting prior authorizations. - Provide professional, courteous, and helpful service to patients, families, coworkers, and other customers. Qualifications: - Associates degree in a related field and/or experience in a medical office, managed care, or medical billing environment preferred. - Previous experience with insurance authorization, medical billing, or healthcare administration preferred. - Knowledge of medical terminology preferred. - CPR certification required or willing to obtain. - Strong computer skills, including Microsoft Office and Excel; experience with an EHR preferred. - Strong attention to detail, organization, communication, and problem-solving skills. - Ability to work effectively with patients, healthcare providers, insurance companies, and other members of the care team. EOE