Pre Auth Specialist-Case Mgmt
About The Position
POSITION INFORMATION Position summary: Contacts insurance companies and other third party payers to determine pre-certification, pre-authorization and/or medical necessity requirements for complex outpatient hospital services, and specialized procedures. Obtains pre-certification or pre-authorization prior to the scheduled service being performed. Liaisons with physicians and physician office staff including peer to peer when needed to obtain additional demographic, insurance or clinical information. Provides clinical support to Patient Connection Center Authorization and Prep Associates or as needed, any pre authorization necessary for any post-acute needs.
Requirements
- Graduate of an accredited or NLN approved RN program.
- Skill and ability in Microsoft Office applications.
- Strong clinical background and knowledge of patient care setting and clinical practices.
- Current Ohio RN license.
Nice To Haves
- Bachelor’s degree preferred.
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What This Job Offers
Job Type
Full-time
Education Level
Associate degree
Number of Employees
501-1,000 employees
