Authorization Specialist | FT | Weekdays | Neurology Clinic | Memphis

Methodist Le Bonheur Healthcare

1d • Onsite

About The Position

Responsible for precertification of eligible medical services and procedures for inpatient, diagnostic, and outpatient services. Ensures complete documentation is obtained that meets insurer guidelines for medical necessity and payment for services. Models appropriate behavior as exemplified in MLH Mission, Vision and Values. Working at MLH means carrying the mission forward of caring for our community and impacting the lives of patients in every way through compassion, a deliberate focus on service expectations and a consistent thriving for excellence.

Requirements

• High School Diploma or Equivalent
• Medical insurance authorizations and/or clinical experience 1-3 years
• Knowledge and experience in coverage practices, terminology, and requirements for referrals and authorization/pre-certification used by third party payers, Medicare, and secondary payer rules.
• Knowledge of CPT, HCPCS, and ICD-10 codes preferred.
• Demonstrated analytical ability to collect and interpret insurance and contract information.
• Experience dealing with PPO and Managed Care insurance.
• Strong attention to detail and critical thinking skills.
• Experience with a computerized healthcare information system required.
• Familiarity with fundamental Microsoft Word software.
• Excellent verbal and written communication skills.

Nice To Haves

• Licensed Practical Nurse - Tennessee - Tennessee Board of Nursing

Responsibilities

• Responsible for precertification of eligible medical services and procedures for inpatient, diagnostic, and outpatient services based on medical plan documents and medical necessity.
• Manages pre-certifications for more complex surgical and invasive procedures that require strong clinical knowledge.
• Coordinates all documentation required for precertification of services.
• Establishes a good working relationship with physicians, physician office staff, patients, and other members of the healthcare team.

Benefits

• The Associate is not substantially exposed to adverse environmental conditions; job functions are typically performed under conditions such as those found in general office or administrative.
• With Methodist Le Bonheur, you’ll be recognized and rewarded, treated with respect and given many opportunities to learn, grow and build a fulfilling career.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED