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Authorization Representative
Ref No.: 17-17056
Location: Emeryville, California
The CAU Authorization and Financial Counselor is generally assigned to one primary work area within the Pre-Access Unit, but may rotate or be assigned to any area or site within the Patient Access Department as outlined in departmental expectations. With the primary assignment area being the CAU, the primary responsibility for the representative is obtaining authorizations for radiology exams/services by working with ordering physician's office staff, the applicable Medical Center ancillary department, and/or review organization(s) as required. In general, the Authorization Counselor is responsible for all spectrums of financially securing the insurance and authorization data for patients' services with insurance coverage that are primarily handled by the Central Authorization Unit. The responsibilities include: 1) verifying basic demographic and clinical information relevant to the patient's radiology exam/services 2) verifying insurance eligibility and benefits, 3) securing authorization from third party payers (and/or their designated review organizations), and 4) properly notating all activity in APeX.




* Two (2) years experience at the Admitting Worker or comparable level.
* Proficiency in health insurance eligibility and authorization requirements.
* Proficiency in reimbursement financial policies.
* Knowledge of government program regulations, MediCal, Medicare, MIA, C.C.S., and other third party payors.