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Preauthorization Coordinator

Appalachian Regional Healthcare

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prestonsburg, ky, usa

Posted 6+ months ago

Preauthorization Coordinator

Job Locations US-KY-Prestonsburg

Requisition ID: 2024-31762
# of Openings: 1
Category: Business Professional
Community: Highlands ARH Regional Medical Center
Posted Date: 22 hours ago(7/3/2024 3:40 PM)
Position Type: Regular Full-Time
Department: Business Office
Shift: Day Shift

Overview

Responsible for insurance verification, pre-certification, pre-authorizations and pre-determination for CT & Vascular procedures in the ARH System. The position requires a thorough understanding of office-management software and a good working knowledge of medical/surgical clinical procedures, claims procedures and insurance company regulations. Requires accuracy, attention to detail and ability to communicate well with physicians, staff, patients and provider representatives of insurance companies.

Responsibilities

Assesses, obtains, verifies and documents patient’s insurance coverage and benefits to determine coverage for procedures.
Achieve the goals and to meet the denial rates to ensure minimum loss of revenue and maximum payment for services.
Obtains pre-certification and/or preauthorization prior to date of procedure with the goal of staying a minimum of one week ahead
Occasionally communicates with patients their benefits and potential out of pocket exposure for procedures ordered by physicians
Accurately documents in computer all referral pre-certification and other information relevant to a patient’s insurance coverage and financial arrangements
Acts as a resource to staff regarding pre-certification processes
Performs other duties as assigned.