Job description

We are seeking a self-motivated, detail-oriented individual for this high volume position. Responsible for verifying eligibility, obtaining and documenting insurance pre-certification/authorizations for a variety of cardiovascular services including physician visits, testing and hospital services.

Essential Functions:

• Verifies health insurance eligibility and obtains benefit information.
• Reviews clinical documentation to ensure it supports the insurance requirements for approval.
• Requests pre-authorization for scheduled visits and procedures.
• Communication with Primary Care Physicians for referrals.
• Accurately notates the account with actions taken for pre-certification.
• Works with other departments when additional information is required.
• Follows up on pending authorization requests in a timely manner.
• Coordinates Peer-to-Peer reviews with Mid-Level Providers for denied requests.
• Communicates with patient prior to procedure to review benefits and provide an estimate of the patient’s financial responsibility.
• Answers call from providers, patients and insurance companies related to authorization/pre-certification requests.

Job Type: Full-time

Pay: $12.00 - $16.00 per hour

Benefits:

• 401(k)
• Health insurance
• Paid time off

Schedule:

• Monday to Friday

Work setting:

• In-person

Application Question(s):

• How many years of insurance eligibility experience do you have?

Experience:

• precertification: 1 year (Required)

Work Location: In person

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