01Overview
This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description Under general direction, this position is responsible for obtaining pre-certifications and pre-authorizations for procedures and medications, and could include scheduling appointments for outpatient testing with other providers, coordinates patient appointments/orders. Obtain timely prior authorization or pre-determinations from all insurances, to include commercial plans, Medicaid, and Medicare Advantage plans, following the company's established policies and protocols. Select accurate and pertinent medical records from patients' charts from client's EMR. Obtain demographic information and verify insurance information. Provide all required clinical information to insurance companies necessary to facilitate the authorization process. Perform complete documentation (within company software or client's EMR) on all prior authorizations follow-ups and determinations appropriately and in a timely manner. Maintain and update internal listing of insurance carriers that require authorization, their processes, and phone and fax numbers. Maintain the strictest confidentiality in accordance with HIPAA regulations and clinic requirements. Qualifications High School Diploma or GED as a basic qualification Proficiency in processing prior authorizations, with at least 5+ years of experience Minimum of 2 years calling and communication with insurance companies via phone Familiarity with medical terminology Strong teamwork capabilities, self-motivation, and reliability Basic computer literacy Reliable, must have the ability to work well in a team setting, and be a self-starter Requirements Experience processing PAs for acute hospital outpatient ancillary services Experience training and working remotely Benefits Access to a 401(k) Retirement Savings Plan. Comprehensive Medical, Dental, and Vision Coverage. Paid Time Off. Paid Holidays. Additional benefits, including Pet Care Coverage, Employee Assistance Program (EAP), and discounted services. Apply tot his job
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Company : RemoteRocketHub
Salary : Work from home .
