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Medical billing/coding experience or pre-authorization experience preferred. Wondering what a day in the life of a Pre-Authorization Specialist at The Iowa Clinic might look like.
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Obtain insurance pre-authorization for procedures, imaging exams, injections and specialty medication prescriptions. You must gather necessary details insurance providers require, submit for pre-authorization and follow up to ensure timely approval with patients scheduled procedures.
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Set shifts and schedulesThe Pre-Authorization Specialist obtains Pre-Authorizations for patient procedures and provides support to the office manager, physicians, billing, clinical staff, referring physicians and most importantly, the patient.
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The Pre-Authorization Specialist is a member of the Pre-Authorization Department who is responsible for verifying eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to the delivery of outpatient and ancillary services.
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We are currently seeking a highly skilled Pre-Authorization Specialist with a minimum of 1 year of recent experience in handling pre-authorizations for a variety of surgical practices, particularly in orthopedics, pain management, and ambulatory surgical centers.
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Financial Clearance Specialists must determine if pre-certification, pre-authorization or a referral is required for insurance companies and obtain if applicable. Submit pre-certification documentation to third party payers for authorization with correct CPT and ICD coding.
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Daily review of charts to determine if pre-certification/pre-authorization or referrals are needed. To ensure procurement of accurate pre-certification authorization/referral for applicable returning and new patients as well as review and completion of accurate, complete patient charts.
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Ensures all policies governing commercial pre-certification and authorization are followed to minimize financial risk. Using discretion and independent judgment, the Payor Relations Specialist manages the pre-certification and prior authorization of referrals scheduled for admission to the Acute Inpatient Rehabilitation Hospital.
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Minimum of 3-5 years as a pre-authorization or utilization review nurse in a payer or acute care setting; preferably medical-surgical or critical care/ED. All clinical pre-authorization activities associated with patients financially cleared through the Patient Access Support Unit (PASU) and/or the Center for Patient Access Services (CPAS.
Full-timeExpandApply NowActive JobUpdated 21 days ago - UpvoteDownvoteShare Job
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Pre-Authorization RN or LPN will coordinate with Pre-Registration and Scheduling staff in order to complete prior authorization for all services and procedures in an accurate, timely and sequential manner.
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Come and join our team as a Pre-Authorization Specialist I for a 9:30-6p shift at our outpatient imaging center located in Raleigh, NC. This career ladder shows your point of entry into our team, as well as the growth and promotional opportunities available to you within our business office department: Pre-Authorization Specialist I.
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The Lead Prior Authorization Specialist is responsible for obtaining benefit coverage information, pre-certification, and pre-authorization for cases referred to A3i and ensuring timely processing of every pre-service review.
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Perform insurance verification and pre-certification follow up for prior day’s walk in admissions/registrations and account status changes by assigned facility. Follow scripted benefits verification pre-certification format in Meditech custom benefits screen and record benefits and pre-certification information.
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Responsible for timely scheduling, pre-authorization, pre-registration, registration and point of service collections for scheduled appointments and procedures, and for registration and point of service collections for non-scheduled patients, receiving care at all Kootenai Health locations.
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Position Summary: In an effort to secure reimbursement for the Hospital, verifies insurance benefits and obtains pre-certification or authorization for Hospital admissions and outpatient procedures.
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