Insurance Specialist/Admin Plastic Surgery Department

Nationwide Children's Hospital•Columbus, OH

1d•Hybrid

About The Position

This role involves participating in the pre-authorization documentation process, which includes obtaining, compiling, maintaining, and issuing necessary records and reports, ensuring accuracy and correct distribution. The specialist will document pre-authorization information in the hospital information system and contact insurance companies to secure pre-authorization for surgeries, office visits, and in-clinic procedures, providing updates as needed. They will also review and follow up on pending pre-authorizations and assist families in establishing care with the Complex Medical Help Program with the State of Ohio. The position is 40 hours/week, Monday-Friday, with one work-from-home day offered weekly. Additionally, the role performs moderately complex administrative duties for department staff.

Requirements

High School Diploma or equivalent
Must complete Ambassador Program within first 12 months of employment.

Nice To Haves

Two years of administrative experience

Responsibilities

Participates in pre-authorization documentation process, obtaining, compiling, maintaining, and issuing necessary records, reports, ensuring accuracy of content and correct distribution.
Documents pre-authorization information appropriately in the hospital information system.
Contacts insurance companies to obtain pre-authorization for surgeries, office visits and in clinic procedures, providing updates as needed throughout the pre-authorization process.
Reviews pending pre-authorizations and provides follow up if needed.
Helps families establish care with Complex Medical Help Program with the State of Ohio.
Provides excellent service to both internal and external customers by applying best practices and standard operating procedures.
Prepares correspondence, documents, reports and other materials which may be moderately complex or confidential, sometimes requiring independent judgment.
Schedules appointments for department staff.
Participates in department projects of moderate scope and complexity.
May provide assistance in training and orientation of colleagues.
May assist in the completion of reimbursement requests for assigned staff.