St Joseph Regional Medical Center Job Vacancies 2020
Detail of : Pre-Authorization Coordinator - Admitting - Full Time Job Openings in Lewiston
PRIMARY (ESSENTIAL) DUTIES
Patient Identification: Identifies patients on surgery schedule for whom Medicare, Medicaid, or insurance companies require pre-admission authorization. Contacts patients scheduled for general admission, surgery or other procedures, to obtain or verify insurance information needed to pre-admit the patient. Contact may be through telephone, letter or direct personal interview. May obtain some patient information from the physician when unable to obtain information.
Pre-auth/cert Verification: . Works with patients, physicians’ offices, Utilization Review Nurses, Charge Capture Specialist and third party representatives as necessary to meet pre-admission requirements. May require reviewing insurance company websites for assistance in determining which services require pre-auth. Assures pre-certification is complete by direct call to insurance companies or by checking with physicians’ offices. May recommend re-scheduling of procedures if appropriate, so that pre-admit criteria may be met.
Benefit Verification: Verifies coverage and obtains benefits online per insurance regulations.
Financial Responsibility to Patient/Staff: Identifies and contacts insurance company representatives to verify and prorate insurance benefits. Informs patients of potential financial responsibility. Records same for use by the insurance, utilization management and credit/collection staff.
Should you are interested and qualified, please apply in confidence by filling online application form at :
All applications are appreciated and will be treated confidentially.
Only short-listed candidates will receive responses.
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