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Preauthorization Coordinator

Appalachian Regional Healthcare

Appalachian Regional Healthcare

prestonsburg, ky, usa
Posted on Thursday, July 4, 2024

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.

Qualifications

Minimum Education

Associates degree or equivalent experience preferred.

Minimum Work Experience

One-year minimum experience working with insurance pre-certification, billing and coding preferred.

Required Skills, Knowledge, and Abilities

Knowledge of current coding for CPT/ICD9/HCPS.

Excellent organizational, communication, and medical terminology.

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