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PRE Authorization Specialist FCH
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- PRE Authorization Specialist FCH
- Job Summary:The Pre-Authorization Specialist is a member of the Pre-AuthorizationDepartment who is responsible for verifying eligibility, obtaininginsurance benefits, and ensuring pre-certification, authorization, andreferral requirements are met prior to the delivery of inpatient,outpatient, and ancillary services.
- This individual determines whichpatient services have third party payer requirements and is responsiblefor obtaining the necessary authorizations for care.
- ThePre-Authorization Specialist provides detailed and timely communicationto both payers and clinical partners in order to facilitate compliancewith payer contractual requirements and is responsible for documentingthe appropriate information in the patient\'s record.
- EXPERIENCE DESCRIPTION: A minimum of 2 years experience inhospital billing/pre-authorization or insurance verification withdemonstrated knowledge of health insurance plans including: Medicare,Medicaid, HMO\'s and PPO\'s required.
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