Job description
Overview:
Internal posting until 4/2/2023. Responsibilities/Job Description:
Completing all insurance requirements in regards to prior authorization and medical necessity in a timely matter. Following all policies and procedures to ensure we are meeting our customer needs timely and efficiently.
Internal posting until 4/2/2023.
- Initiate prior authorizations as required by payers for any outpatient tests and treatment as well as inpatient admissions.
- Obtains pre-certification for all inpatient and outpatient surgeries.
- Obtains pertinent information and prior authorizations for workers compensation cases.
- Completes all requirements for the provision of initial care and any require insurance referrals for specialty care.
- Maintains current knowledge of insurance requirements and accurately performs duties in a timely manner in gathering and entering of medical insurance information.
- Protects and maintains confidentiality and privacy of all prior authorization, medical necessity and member information.
- Provides clinical information to insurance companies for prior authorization according to our policies and procedures.
Required:
- High school diploma or equivalent.
- 1 year experience in a related Healthcare field, such as Patient Access and/or Billing.
- Computer, phone etiquette, and customer service experience.
Preferred:
- Healthcare related associates degree.
- 2 to 3 years of experience in a related Healthcare field, such as Patient Access and/or Billing.
- Knowledge of health insurance billing preferred.
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