Address
Form of work- JOB SUMMARY
- Secure pre-authorization for inpatient IRF, Pediatrics, and LTACH admissions
- Facilitate peer to peer and/or family appeals when needed
- ESSENTIAL FUNCTIONS
- Secures necessary pre-authorization in an accurate and timely manner
- Acts as a patient advocate between the patient and insurance company
- Communicates authorization status clearly to Clinical Liaison and office team
- Maintains authorization work lists in Cerner
- Research denials due to authorization or referral issues and determine cause and resolution, re-submits claims when appropriate after gathering necessary information
- Recognizes time sensitivity of completion of cases and commits to daily completion
- Answers patients' calls regarding authorization questions
- Must be deadline driven, sense of urgency and collaborative to prevent delays in admission
- Contributes to a positive work environment
- Contributes to the overall team efforts
- QUALIFICATIONS:
- To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Education
- High School diploma required
- Associates degree preferred
- Work Experience
- 1-2 years in health insurance authorization process (hospital experience) preferred
- Previous call center experience or similar, high volume environment preferred
- Licenses / Certifications
- LPN, COTA, or PTA required
- Education
- To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
