Preauthorization Coordinator
US-KY-Harlan
careers
Req #: 34878
Type: Regular Full-Time
|
|
|||||||||
|
||||||||||
Overview: Responsible for insurance verification, pre-certification, pre-authorizations and pre-determination for CT & Vascular procedures in the ARH System. The position requires a thorough understanding of office-management software and a good working knowledge of medical/surgical clinical procedures, claims procedures and insurance company regulations. Requires accuracy, attention to detail and ability to communicate well with physicians, staff, patients and provider representatives of insurance companies. Responsibilities: * Assesses, obtains, verifies and documents patient's insurance coverage and benefits to determine coverage for procedures. * Achieve the goals and to meet the denial rates to ensure minimum loss of revenue and maximum payment for services. * Obtains pre-certification and/or preauthorization prior to date of procedure with the goal of staying a minimum of one week ahead * Occasionally communicates with patients their benefits and potential out of pocket exposure for procedures ordered by physicians * Accurately documents in computer all referral pre-certification and other information relevant to a patient's insurance coverage and financial arrangements * Acts as a resource to staff regarding pre-certification processes * Performs other duties as assigned. Qualifications: Minimum Education * Associates degree or equivalent experience preferred. Minimum Work Experience * One-year minimum experience working with insurance pre-certification, billing and coding preferred. Required Skills, Knowledge, and Abilities * Knowledge of current coding for CPT/ICD9/HCPS. * Excellent organizational, communication, and medical terminology.
Share this job:
