What are the responsibilities and job description for the Central Intake Precertification Coordinator position at Nexion Health Management?
Central Intake Precertification Coordinator
Your talents, skills and heart are in high demand. Join our team of collaborative healthcare professionals and work closely with a cross-functional team to create an environment of quality health and wellness of the minds, bodies and spirits of our residents. APPLY TODAY!
About Us
Over the past 20 years, Nexion has grown to 57 affiliate skilled nursing and rehabilitation, as well as assisted living facilities in Louisiana, Mississippi and Texas. Our collaborative and compassionate culture provides a platform for team members to share their talents and skills to facilitate continuous improvement across the entire organization. Nexion has also taken an active stance for diversity and inclusion by establishing a Diversity Task Force to tear down divisive barriers and build unity of cultures and purpose. Our commitment to excellence begins with the unity of our team for the care of our residents, which is reflected in our positive clinical outcomes, resident and family member testimonials, customer satisfaction ratings, AHCA Quality Awards and the advancement and tenure of our associates. We invite you to experience the Nexion culture and grow with us.
RESPONSIBILITIES:
This position will be responsible for making the outbound calls to all necessary private payors to verify benefit coverage and eligibility. This position will be responsible for providing accurate, timely and complete information for all resident admissions making the way for clean and accurate claims filing.
ESSENTIAL FUNCTIONS:
- Experience in performing all aspects of insurance verification for Commercial Insurance
- Efficient in acquiring information from medical providers and posting verified insurance information into systems for patient registration
- Reviews for accuracy
- Verifies all patient medical information and prior authorizations by calling primary, secondary and third party payers
- Performs these tasks in a timely, efficient and error free manner
- Performs telephonic support for online authorization of routine services
- Provides direct support to facilities and care providers regarding utilization, authorization, and referral activities
- Becomes proficient in the use of ICD-9 and CPT codes
- Data entry referrals for services including inpatient and outpatient care
- Contacts providers with authorization, denial, and appeals process information
- Assists in educating and acts as a resource to primary care practices and specialty care providers
- Provides precertification of members and participating network status of providers
- Determines member benefit coverage requirements:
QUALIFICATIONS:
- Requires 1 to 2 years of experience working in a medical office or hospital
- Knowledge of Medical Insurances Required
- At least one year of pre – cert experience, including navigating websites for online benefit reviews
- Excellent computer, multi – tasking and phone skills
- Ability to work well under pressure in a highly time-sensitive environment, be a team player and willing to perform diversified job duties
- 2 years of recent high-volume pre – cert/insurance verification experience
- High School graduate
We offer a great work environment, competitive compensation, and excellent benefits, which include: 100% Paid Vacation/Sick. Medical, Dental, Vision, 401k, FSA, ST and LT Disability, Life Insurance and AD and D.
