- Process incoming authorization packets and medical records requests, entering and validating data against source documents.
- Resolve missing Client ID and authorization-on-file issues, coordinating with VAMCs, Community Care, and EAP partners as needed.
- Audit BPO authorization entry for accuracy and track performance against productivity standards.
- Research and resolve authorization-related claim denials, identifying trends and escalating systemic issues with supporting evidence.
- Submit and track RFS forms and other renewal or reauthorization requests.
- Maintain accurate, up-to-date authorization records across internal systems.
- Partner with Billing and Eligibility to keep claims moving cleanly through the Pre-Bill process.
EHR