Precertification Coordinator
About The Position
Coordinate with physicians offices and insurance companies in obtaining authorization for all hospital admissions. Obtain authorization on for admissions as required by health plans. Enter patient insurance authorizations and any pertinent information from insurance company into the patient account history. Documents insurance coverage of services to be provided. Notifiy case management about interactions with insurance companies regarding services. Manage denials or potential denials as described by insurer. Monitor and review applicable schedule to ensure that authorization and initial length of stay is obtained and on file.
Requirements
- High School diploma equivalency OR 1 year of applicable cumulative job specific experience required.
- Note: Required professional licensure/certification can be used in lieu of education or experience, if applicable.
Nice To Haves
- Coordinate with physician offices and insurance companies in obtaining prior authorizations.
- Enter patient insurance authorizations and any pertinent information from insurance company into the patient chart. Document insurance coverage of services to be provided.
- Manage denials or potential denials as described by insurer.
- Monitor and review applicable schedule to ensure that authorization is secured within appropriate time frame.
- Previous surgical/procedure prior authorization experience required
- Previous Cardiology experience preferred
- Previous experience working remotely preferred.
- Previous coding experience preferred.
- Previous Epic experience preferred.
Responsibilities
- Coordinate with physicians offices and insurance companies in obtaining authorization for all hospital admissions.
- Obtain authorization on for admissions as required by health plans.
- Enter patient insurance authorizations and any pertinent information from insurance company into the patient account history.
- Documents insurance coverage of services to be provided.
- Notifiy case management about interactions with insurance companies regarding services.
- Manage denials or potential denials as described by insurer.
- Monitor and review applicable schedule to ensure that authorization and initial length of stay is obtained and on file.
Benefits
- Paid time off (PTO)
- Various health insurance options & wellness plans
- Retirement benefits including employer match plans
- Long-term & short-term disability
- Employee assistance programs (EAP)
- Parental leave & adoption assistance
- Tuition reimbursement
- Ways to give back to your community
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Industry
Religious, Grantmaking, Civic, Professional, and Similar Organizations
Education Level
High school or GED
Number of Employees
5,001-10,000 employees
