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SalaryWe are seeking a self-motivated, detail-oriented individual for this high volume position. Responsible for verifying eligibility, obtaining and documenting insurance pre-certification/authorizations for a variety of cardiovascular services including physician visits, testing and hospital services.
Essential Functions:
- Verifies health insurance eligibility and obtains benefit information.
- Reviews clinical documentation to ensure it supports the insurance requirements for approval.
- Requests pre-authorization for scheduled visits and procedures.
- Communication with Primary Care Physicians for referrals.
- Accurately notates the account with actions taken for pre-certification.
- Works with other departments when additional information is required.
- Follows up on pending authorization requests in a timely manner.
- Coordinates Peer-to-Peer reviews with Mid-Level Providers for denied requests.
- Communicates with patient prior to procedure to review benefits and provide an estimate of the patient’s financial responsibility.
- Answers call from providers, patients and insurance companies related to authorization/pre-certification requests.
Job Type: Full-time
Pay: $12.00 - $16.00 per hour
Benefits:
- 401(k)
- Health insurance
- Paid time off
Schedule:
- Monday to Friday
Work setting:
- In-person
Application Question(s):
- How many years of insurance eligibility experience do you have?
Experience:
- precertification: 1 year (Required)
Work Location: In person
