Role Overview

The Insurance Coordinator OP Approvals manages outpatient insurance approvals and authorization workflows. You ensure timely approvals accurate documentation and compliance with payer rules. You protect revenue by preventing authorization denials and treatment delays.

Key Objectives

Operational Control

• Ensure all outpatient services receive approvals before treatment.
• Maintain zero tolerance for unauthorized services.

Performance Metrics

• Achieve approval turnaround within payer SLA timelines.
• Maintain less than 3 percent denial rate due to authorization errors.

Compliance

• Ensure adherence to DHA regulations and payer policies.
• Maintain complete audit ready authorization records.

Core Responsibilities