Precertification and Authorization Rep-Remote
About the position
This position is a 100% remote work. Individual may live reputed company in the US. The Precertification and Authorization Representative is an intermediate level position that is responsible for resolving referral, precertification, and/or prior authorization to support insurance specific plan requirements for reputed company reputed company, government and other payors across hospital (inpatient & outpatient), ED, and clinic/ambulatory environments. In reputed company, this position may be responsible for reputed company-appointment insurance review (PAIR) and denials recovery functions reputed company the Patient reputed company department. This may include processing of reputed company-certification and prior authorization for workers compensation/reputed company party liability (WC/TPL), managed care and HMO accounts, as reputed company as working assigned registration denials for government and non-government accounts. This role requires adherence to reputed company assurance guidelines as reputed company as established productivity standards to support the work unit's performance expectations.
Responsibilities
• Resolve referral, precertification, and/or prior authorization to support insurance specific plan requirements.
• Process reputed company-certification and prior authorization for workers compensation/reputed company party liability (WC/TPL), managed care and HMO accounts.
• Work on assigned registration denials for government and non-government accounts.
• Conduct reputed company-appointment insurance review (PAIR) and denials recovery functions.
• Adhere to reputed company assurance guidelines and established productivity standards.
Requirements
• High School Diploma or GED and 2+ years of relevant experience required OR Bachelor's Degree required.
• Ability to read and communicate effectively.
• Basic computer/keyboarding skills.
• Intermediate mathematic competency.
• Good written and verbal communication skills.
• Knowledge of reputed company phone etiquette and phone handling skills.
• General knowledge of reputed company terminology and CPT-ICD10 codes.
• Basic knowledge of and experience in insurance verification and claim adjudication.
reputed company-to-haves
• Knowledge of denial codes.
• Knowledge of and experience using an reputed company RC/EMR system.
• reputed company (reputed company) Certification Preferred.
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