Authorization Coordinator - PACE Southeast Michigan : Job Details

Job Category: Rehabilitation

Requisition Number: AUTHO003947

Posted: October 24, 2024

Full-Time

Corporate | CORP

21700 Northwestern Hwy. Ste. 900 Southfield, MI 48075, USA

AUTHORIZATION COORDINATOR

POSITION SUMMARY:

Reporting to the Sr. Director Operational Support & Innovation and the Director Finance, and working under the general guidance of the Authorization Nurse, the Authorization Clerk will assist with the processing of assigned authorizations. This will include but not be limited to oversight of accurate entry or information and completion, education, and monitoring of key areas for incomplete records in conjunction with clinical and supportive staff.

SPECIFIC DUTIES AND FUNCTIONS:

• Coordinate authorization information for all participant care needs with interdisciplinary team (IDT) members ensuring completeness of all required information.
• In tandem with Authorization Nurse, monitor all participant authorizations in EMR for accuracy and correct information.
• Provide education to IDT staff regarding authorization processing and management to improve compliance where required.
• Follow-up on assigned authorizations for completion of missing data.
• Monitor EMR (currently TruChart) for authorization status, notifying individuals and leadership of any trends or issues relating to timeliness, error rates, or similar quality issues.
• Monitor EMR Utilization module for pending authorization reviews and facilitate completion.
• Request discharge summaries and other key information for care partners/hospitals; coordinate input to EMR with PACE Medical Records.
• Other duties as assigned.

KNOWLEDGE, SKILLS, AND ABILITIES REQUIRED:

• Associate Degree in Health Information Technology or equivalent experience required.
• Minimum 2 years' experience in a managed care environment, preferably in a utilization related role;
• Must have one year of experience with a frail, elderly population

WORK ENVIRONMENT:

Professional office environment

Occasional interaction with participants with risk of exposure to communicable diseases

Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.