Precertification Representative

HCA Healthcare•Nashville, TN

2d•Remote

About The Position

The Precertification Representative requests, obtains, and follows up on authorization requests, coordinating with patients, physician offices, facilities, and insurance companies. The role processes requests promptly, supports scheduling with minimal delay, uses department systems accurately, and provides patients and physician staff with instructions about authorization requirements, test preparation, and registration. The representative maintains knowledge of scheduled procedures and checks orders for compliance with Medicare guidelines and department standards. This is a work-from-home position. Employees must live and perform the job within 60 miles of an HCA Healthcare hospital. Virtual employees must have wired high-speed internet with at least 25 Mbps download and 15 Mbps upload speeds. The role uses Meditech, the Orders Management System, call-center equipment, and payer websites. It may also assist with orienting new employees and serve as a departmental resource.

Requirements

High school diploma or GED preferred.
One year of precertification experience preferred.
Previous call center experience preferred.
Meditech experience is a plus.
Virtual employees must have wired high-speed internet with at least 25 Mbps download and 15 Mbps upload speeds.
Remote employees must live within 60 miles of an HCA hospital.

Nice To Haves

High school diploma or GED.
One year of precertification experience.
Previous call center experience.
Meditech experience.

Responsibilities

Request, obtain, and follow up on authorization requests.
Process phoned and faxed requests promptly and in a timely manner.
Handle STAT requests and interdepartmental scheduling promptly.
Contact facilities, physician offices, and insurance companies to resolve denials and appeals.
Schedule patient tests and procedures in a prompt and courteous manner.
Use Meditech features correctly and enter necessary information accurately.
Instruct patients and physician staff on authorization requirements, test preparation, and registration information.
Establish and maintain working knowledge and vocabulary of scheduled procedures.
Process requests for diagnostic procedures and coordinate the Peer to Peer function as needed.
Check patient orders for compliance with Medicare guidelines.
Process physician orders according to department standards.
Assist with orientation of new employees as needed and serve as a departmental resource.
Handle difficult or interdepartmental requests with confidence and provide knowledgeable, helpful customer service.

Benefits

Comprehensive medical, prescription drug, dental, vision, behavioral health, and telemedicine benefits.
Wellbeing support, including free counseling and referral services.
Paid time off and paid family leave.
Long- and short-term disability coverage and leaves of absence.
401(k) plan with a 100% match on 3% to 9% of pay, based on years of service.
Employee Stock Purchase Plan.
Flexible spending accounts.
Tuition assistance, student loan assistance, certification support, dependent scholarships, and a partnership with Galen College of Nursing.
Fertility and family-building benefits and adoption assistance.
Life insurance and supplemental health protection plans.
Auto and home insurance, legal counseling, identity theft protection, and consumer discounts.