Come work at the best place to give and receive care!
Position Summary
Job Description:
To ensure that precertification is completed for patients which is required by insurance payors.
Key Responsibilities
Obtains insurance verification and precertification for applicable patients based on payor requirements, and documents in system.
Interacts with staff to share information and receive updates regarding patient status or procedure.
Interact with Patient Accounts to resolve billing and precertification issues. Provides supportive documentation as needed.
Verifies all self-pay accounts and conducts any necessary research to determine absence of any other insurance.
Obtains approval to ensure that clinical information is provided to insurance companies and authorization is complete.
Educates staff on the process required for precertification.
Fills out all necessary authorization request forms and submits to insurance companies.
Verifies accuracy of information by identifying patient’s name and date of birth, which may involve the use of patient files.
Researches ICD-9 and ICD-10 coding (to pre-cert only) and outpatient diagnostic and clinic records.
List the diseases/conditions documented within the current admission or office visit.
Develops the proficiency necessary on current equipment used including word processors, mainframe computer terminals, or other such devices.
Follows specified procedures for dispatching finished reports to designated person(s) for approval and signature, and for dispatching copies to appropriate parties.
Maintains all logs, records, or other files necessary to accurately track production for present and future references.
Exercises care in the use and operation of Elliot Hospital equipment and reference materials.
Ensures routine preventive maintenance to ensure continued functioning of equipment.
Ensures confidentiality of employee, legal, client/patient, budget and all company matters.
Monitors schedule and staff messages for anything requiring authorization.
Maintains files for easy retrieval of material and secures confidential information.
Answers telephone, assists callers, takes messages, or refers call to appropriate person.
Reports all equipment failures or impending failures promptly to the Manager.
Schedules appointments once required prior authorizations are obtained.
Coordinates with patients to schedule and provide updates.
Education/Experience/Licensure
Education: High school diploma or equivalent with courses in typing and computer skills required; medical terminology preferred.
Experience: Experience in customer service relations and office experience preferred.
Work Shift
M-F 32 Hours
SolutionHealth is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, disability status, veteran status, or any other characteristic protected by law.
Seniority level
Entry level
Employment type
Part-time
Job function
Health Care Provider
Industries
Construction, Renewable Energy Semiconductor Manufacturing, and Oil and Gas
Referrals increase your chances of interviewing at SolutionHealth by 2x