Proven Remote Pre-Authorizations Rep

• The Patient Access Authorization Specialist performs insurance authorization. Functions are primarily completed via website and / or phone and include insurance verification, authorization, payor notification and ensuring that the correct date of service, facility, diagnosis and service / exam type are documented.
• The specialist may also escalate authorization requests in order to facilitate peer to peer discussions between the payor and provider or notify the provider’s office of denials.
• The Authorization Specialist ensures that all contact with patients, providers and payors is documented with detailed notes included for each account worked.
• Capture post service or retro authorizations or support additional functions including scheduling, registration, financial navigation, medical necessity, patient liability notification and screening.
• Work closely with clinical care teams and at times will support Access functions within the clinical care environment.
• Provide internal and external customer service support for clinicians, patients and families.
• Must be sensitive patient situations.
• Must convey a caring and professional attitude in all interactions. Partnership with Care Management.
• Authorization for urgent and emergent admission,high dollar o / p and surgical procedures
• Must have 5 years plus Pre-Authorization Experience
• Must have Hospital Experience
• Must have Epic Grand Central Experience

Last updated : 2024-06-20