Unit Coordinator at ALLIANCE HEALTHCARE SERVICES, INC

Memphis, Tennessee, United States -

Full Time

Start Date

Immediate

Expiry Date

16 Jul, 26

Salary

0.0

Posted On

17 Apr, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Insurance authorization, Utilization review, Healthcare billing, Compliance reporting, Regulatory standards, Electronic health records, Medical necessity criteria, Revenue cycle integrity, Data analysis, Interdisciplinary collaboration, Process improvement, Documentation management, Attention to detail, Organizational effectiveness, Communication skills

Industry

Hospitals and Health Care

Description

Position Summary The Unit Coordinator is responsible for managing front-end insurance authorization processes, facilitating concurrent reviews, and supporting state-specific insurance billing requirements. This role ensures coordinating timely compliance reporting and collaborates closely with leadership and the compliance department to maintain adherence to regulatory standards. The position is integral to optimizing reimbursement, minimizing denials, and ensuring operational and regulatory alignment. Qualifications Education * High school diploma or equivalent required * Associate’s or Bachelor’s degree in healthcare administration, business, or related field preferred Experience * Minimum of 2–3 years of experience in insurance authorization, utilization review, or healthcare billing * Experience with state-funded insurance programs and behavioral health settings strongly preferred * Demonstrated experience in compliance-related processes within a healthcare environment Skills & Competencies * Strong knowledge of insurance authorization processes, medical necessity criteria, and payer requirements * Working knowledge of state insurance billing regulations and compliance standards * High level of attention to detail and organizational effectiveness * Ability to manage multiple deadlines and prioritize in a fast-paced environment * Effective communication and collaboration skills across interdisciplinary teams * Proficiency in electronic health records (EHR) and billing systems Key Responsibilities Insurance Pre-Certification & Authorization * Initiate and secure insurance pre-certifications for all admissions in accordance with payer requirements. * Verify eligibility, benefits, and coverage limitations prior to or at the time of admission. * Maintain accurate tracking of authorization status, approved days, and required follow-up actions. * Communicate proactively with payers to prevent authorization gaps and mitigate risk of non-reimbursable days. Concurrent Review & Continued Stay Management * Conduct and coordinate concurrent reviews with insurance providers to obtain continued stay approvals. * Collaborate with the treatment team to ensure documentation supports medical necessity. * Submit clinical updates to payers within required timeframes to support ongoing authorization. * Escalate potential denials or insufficient documentation concerns to leadership and appropriate stakeholders. State Insurance Billing Processes * Implement and facilitate state-specific insurance billing processes in alignment with regulatory requirements. * Ensure accurate and timely submission of billing-related information to support claims processing. * Monitor billing workflows to ensure compliance with payer and state guidelines. * Partner with the business office to resolve billing discrepancies and support revenue cycle integrity. Compliance Coordination & Reporting * Coordinate timely compliance reviews related to authorizations, billing, and payer requirements. * Prepare and submit required reports to the compliance department, ensuring accuracy and completeness. * Identify trends, gaps, or risks related to compliance and escalate as appropriate. * Maintain thorough documentation to support internal audits and external regulatory reviews. Staff Training & Compliance Collaboration * Work collaboratively with the compliance department to identify and communicate staff training needs * Ensure training requirements are disseminated to appropriate staff in a timely manner. * Maintain and update training trackers and documentation to ensure compliance with organizational standards * Support leadership in reinforcing compliance expectations and accountability. Collaboration & Leadership Support * Work collaboratively with facility leadership to ensure compliance-related objectives and performance targets are achieved. * Serve as a liaison between admissions, utilization review, clinical teams, billing, and compliance. * Participate in multidisciplinary meetings to provide updates on authorization, billing, and compliance metrics. * Support process improvement initiatives aimed at enhancing efficiency, compliance, and reimbursement outcomes. Operational Coordination- Meal Count Oversight * Provide oversight and coordination of daily meal counts for the Crisis Stabilization Unit (CSU) and Crisis Assessment Center (CAC). * Ensure accurate and timely communication of meal counts to the designated vendor. * Reconcile discrepancies and maintain documentation related to meal services. * Collaborate with unit staff and vendors to ensure efficient service delivery. Patient Assistance * Complete process for patients to receive medication through United Way * Assist/Complete process to enroll patients in safety net.

Responsibilities

The Unit Coordinator manages front-end insurance authorization, concurrent reviews, and state-specific billing processes to ensure regulatory compliance and revenue cycle integrity. They also provide operational oversight for unit meal counts and support patient assistance programs.