Precertification Representative

Introduction

Do you want to join an organization that invests in you as a Precertification Representative? At Parallon, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years.

Benefits

Parallon, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

• Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
• Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
• Free counseling services and resources for emotional, physical and financial wellbeing
  
• 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
  
• Employee Stock Purchase Plan with 10% off HCA Healthcare stock
  
• Family support through fertility and family building benefits with Progyny and adoption assistance.
  
• Referral services for child, elder and pet care, home and auto repair, event planning and more
  
• Consumer discounts through Abenity and Consumer Discounts
  
• Retirement readiness, rollover assistance services and preferred banking partnerships
  
• Education assistance (tuition, student loan, certification support, dependent scholarships)
  
• Colleague recognition program
  
• Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
  
• Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.

Learn more about Employee Benefits

Note: Eligibility for benefits may vary by location.

You contribute to our success. Every role has an impact on our patients’ lives and you have the opportunity to make a difference. We are looking for a dedicated Precertification Representative like you to be a part of our team.

Job Summary and Qualifications

The Precertification Representative is responsible for requesting, obtaining and following up on authorization requests. Manage stat requests and interdepartmental scheduling with minimal delay to customer. Correct utilization of all systems and accurately enters all mandatory information. Provides instructions to patients and physician’s staff on authorization requirements and information. Establish and maintain a working knowledge and vocabulary of scheduled procedures. Manage daily operations including but not limited to: Meditech, Orders Management System, Call Center Equipment (phones, etc.), payer websites.

In this role you will:

• Requests, obtains and follows up on authorization requests
• Processes Phoned and/or faxed requests processed in a prompt and timely manner
• Stat requests and interdepartmental scheduling processed promptly;
• Contacts the facilities, physicians’ offices and/or insurance companies to resolve denials/appeals
• Schedules patient tests, and/or procedures in a prompt, courteous manner;
• Correctly utilizes the features of the Meditech system and accurately enters necessary information;
• Instructs patients and physician staff on authorization, test preparation and registration information;
• Establishes and maintains a working knowledge and vocabulary of procedures scheduled;
• Demonstrates the willingness and ability to process requests for diagnostic procedures and coordinates the Peer to Peer function as needs arise
• Checks patient orders for compliance with Medicare guidelines
• Processes physician’s orders in accordance with department standards
• Assists with orientation of new employees as needed and serves as a resource within the department;
• Displays confidence when processing difficult or interdepartmental requests;
• Recognized by customers as knowledgeable and helpful

Qualifications:

• High school diploma or GED preferred.
• One year of precertification experience preferred
• Previous Call Center Experience preferred
• Meditech experience a plus
• Virtual Employees are required to have wired High Speed Internet Speed 25 MBS Download and 15 MBS Upload

Parallon provides full-service revenue cycle management, or total patient account resolution, for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers and their communities.

HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

"Good people beget good people."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder

We are a family 270,000 dedicated professionals! Our Talent Acquisition team is reviewing applications for our Precertification Representative opening. Qualified candidates will be contacted for interviews. Submit your resume today to join our community of caring!

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.