- Works closely with department physicians and staff, coding and billing staff, to ensure understanding of information needed to obtain proper authorization for payment.
- Communicates with patients prior to specialty consultation or surgical procedure to provide them with information regarding their coverage.
- Identifies what is required for Preauthorization of surgical procedures and completes the process to minimize denial of claims.
- Preauthorization documentation.
- Communicate with hospitals and patient on progress/approval of Preauthorization.
- High School Diploma and/or GED Required
- 1-3 years One year of experience in a medical or insurance role Preferred
- General computer knowledge needed to navigate electronic medical record and for documentation.
- Excellent organizational skills.
- Excellent communication skills and follow through with internal and external customers.
- Knowledge of insurance and medical terminology.
- Knowledge of CPT/ICD-9 coding useful.
- Sit - Constantly
- Stand - Rarely
- Walk - Rarely
- Drive - Rarely
- Climb (Stairs/Ladders) - Rarely
- Bend (Neck) - Frequently
- Gross Manipulation (Hands/Arms) - Constantly
- Squat - Rarely
- Twist/Turn (Neck) - Occasionally
- Lift/Carry 0-10 lbs. - Rarely
- Lift/Carry 11-25 lbs. - Rarely
- Lift/Carry 26-35 lbs. - Rarely
- Push/Pull up to 10 lbs. - Rarely
- Push/Pull 11-25 lbs. - Rarely
- Push/Pull 26-35 lbs. - Rarely
- Reach (Above shoulder level) - Rarely
- Reach (Below shoulder level) - Constantly
- Simple Grasping (Hands/Arms) - Constantly
- Fine Manipulation (Hands/Arms) - Constantly
- Gross Manipulation (Hands/Arms) - Constantly
- Noise - Occasionally
- Hears Whispers < 3 feet - Constantly
- Hears Whispers 3-8 feet - Constantly
- Color Discrimination - Constantly
- Near Vision (Correctable to Jaeger 2 or 20/30 binocular) - Constantly
- Distance Vision (Correctable to Snellen chart 20/30 binocular) - Constantly
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Prevea Health Green Bay, United States Part time· This position will work 24 hrs per week · Prior Authorization Specialist · Come work where we specialize in you We have nearly 2,000 reasons for you to consider a career with Prevea Health-they're our employees. We're an organization that values kindness, responsibility, inc ...
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Prior Auth Specialist- Plastic Surgery- Holmgren Way - Green Bay, United States - Prevea Health
Description
This position will work 24 hrs per weekPrior Authorization Specialist
Come work where we specialize in you We have nearly 2,000 reasons for you to consider a career with Prevea Health-they're our employees.
Job Summary
Providing exceptional care for our patients as well as recognizing the value of your co-workers is the expectation of all members of the Prevea Health organization.
All members are expected to focus on the patient's needs; relate to all in a friendly, accepting manner; communicate in a positive and professional way to patients and co workers; use time effectively and efficiently; and demonstrate an overall high level of performance.
What you will doIn compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United State and to complete the required employment eligibility document form upon hire.
Prevea participates in E-verify. To learn more about E-Verify, including your rights and responsibilities, please visitEqual Opportunity Employer Minorities/Women/Protected Veterans/Disabled