The Pre-Certification Authorization Coordinator is responsible for obtaining pre-certification for all inpatient admissions and pre-authorization for all outpatient diagnostic tests while performing an administrative support function. This role requires the application and interpretation of policies and procedures, as well as the use of independent judgment in a medical setting. The primary goal is to achieve the targets set by Patient Access at the Medical Center and HSF to minimize revenue loss and maximize payment for services. The coordinator must maintain a working knowledge of carrier contracts and departmental policies and procedures. Responsibilities include analyzing information required for pre-certifications and authorizations with insurance carriers and workman's compensation carriers, demonstrating proficiency in the use of PC and UVA software systems, and ensuring accurate and timely entry of pre-certification/pre-authorization information. Effective communication, decision-making, and organizational skills are essential for job performance and success. Adherence to policies and procedures is also required. Additional duties may be assigned as necessary.
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Job Type
Full-time
Career Level
Entry Level
Industry
Hospitals
Education Level
High school or GED