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Reimbursement Coordinator Associate

KDMC Ashland Hospital Corporation · United States

Diagnostics / LaboratoryJunior LevelExternal listingfull-time1 day ago

About The Role

At UK King's Daughters, we’re not just a healthcare facility — we’re a family of dedicated professionals who share a passion for making a meaningful difference in the lives of our patients. We’re more than just a place to work; we’re a place to grow, thrive, and contribute to our community.

Job Description

Job Summary

Responsible for coordinating insurance authorization and pre-certification for scheduled medications and laboratory tests. Communicates denials to appropriate parties as necessary. Ensures timely and accurate processing of all insurance-related documentation. Collaborates with clinical and administrative teams to support patient care and access. Maintains compliance with regulatory and payer requirements.

Essential Functions

  • Tracks, obtains, and extends authorizations in a timely manner.
  • Records insurance information using standardized documentation practices.
  • Obtains, interprets, and submits clinical documentation for prior authorization.
  • Obtains and documents prior authorization approvals from insurance companies.
  • Communicates authorization status or delays to providers and clinical staff.
  • Follows up on denied authorization requests.
  • Facilitates peer-to-peer conversations between insurance carriers and providers.
  • Supports claim denial appeal efforts related to prior authorizations.
  • Performs other duties as assigned.

Education Requirement

High school diploma or equivalent experience

Experience Requirement

  • 0-2 years of experience in a healthcare, clinical setting, or a relevant area
  • An equivalent combination of education and experience may be considered.
  • All experience must be paid and in the same related field.
  • Part-time and PRN experience will be prorated based on hours worked per week.
  • Volunteer work and internships for academic credit are not counted.

Certifications & Licensures

N/A

Working Conditions

  • A. Lifting, pushing, and/or pulling objects up to 50lbs: 2. Occasional ( B. Lifting, pushing, and/or pulling objects over 50lbs: 1. Never
  • C. Standing or walking with objects up to 10lbs: 3. Intermittent (10% - 50% of the time)
  • D. Standing or walking with objects up to 25lbs: 2. Occasional ( E. Sitting at computer workstation for extended periods: 4. Regular (> 50% of the time)
  • F. Risk of back injury from moving, lifting or positioning patients, equipment, or materials: 1. Never
  • G. Repetitive motion: 4. Regular (> 50% of the time)
  • H. Working at heights above 4 feet: 1. Never
  • I. Working in confined spaces: 1. Never
  • J. Risk of injuries from use of equipment on the job: 1. Never
  • K. Job-related travel: 2. Occasional ( L. Loud noises: 1. Never
  • M. Temperature extremes: 1. Never
  • N. Hazardous chemicals and fumes including waste: 1. Never
  • O. Radiation: 1. Never
  • P. Burns: 1. Never
  • Q. Cuts/Punctures: 1. Never
  • R. Bloodborne/airborne pathogens: 1. Never
  • S. Recombinant DNA or viral vectors: 1. Never
  • T. Combative/violent people: 1. Never
  • U. Animal handling (including carcasses): 1. Never
  • V. Please specify other(s) and amount of exposure (i.e. Occasional, Intermittent or Regular): N/A

Physical Demands

This position requires regular sitting at a computer workstation for extended periods of time; performing tasks with repetitive motions (such as typing); intermittent standing or walking with objects weighing up to 10 pounds; and occasional lifting, pushing, and/or pulling of objects weighing up to 50 pounds. Occasional job-related travel may also be required.

Additional Job Descriptions

N/A

Department

KDIP FAC TriStat Hema-Oncology

Shift

Days (United States of America)

Time Type

Full time

Address

2201 Lexington Avenue

City, State

Ashland, Kentucky

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