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Insurance Pre-Authorization Specialist 
(Job)

resume-library  |  United States  |  

Ref:
PARTNER-3Z3QRC
Direct:
Employer:
Location:
United StatesUnited States (US)
Category:
Banking & Insurance/Insurance
Work Type:
Permanent
Work Time:
Full Time
Tags:
job,united-states,resume-library

Description 

Insurance Pre-Authorization Specialist

Reviews referring physician and patient documentation for Medical Necessity against insurance protocol requirements for pre-certification purposes.



Actively communicates with staff regarding status of authorization. Communicates the need for reschedule and/or cancellation if authorization not in-hand).



Direct liaison to offices and patients regarding new, changed, or pending insurance authorizations, as well as on-going education of changes in authorization requirements. Will be located on-site to allow for face-to-face interactions with patients and/or referring providers when necessary.



Responsible for scheduling STAT, emergent patients for outpatient diagnostic exams. Interacts with patients, their representatives, physicians, physician office staff, and others to gather and ensure accuracy of demographic, billing and clinical information. Produces and distributes required forms with accurate patient information.



Respects and protects the patient’s rights to confidentiality and privacy and discloses information only for the professional purposes which are in the patient’s best interests with full consideration of their legal rights. Displays a positive attitude when interacting with provider’s office staff, providers and fellow employees.



Benefits



Medical Insurance



Dental Insurance



Vision Insurance



401K