Precertification Representative

About the Role

This Work from Home position requires that you live and perform the duties of the position within 60 miles of an HCA Healthcare Hospital (located in the following states: FL, GA, ID, KS, KY, MO, NV, NH, NC, SC, TN, TX, UT, VA). At Parallon, we invest in our team members, offering support and growth opportunities.

Responsibilities

• Request, obtain, and follow up on authorization requests with minimal delay to customers.
• Process phoned and/or faxed requests promptly and accurately.
• Schedule interdepartmental requests and resolve denials/appeals by contacting facilities, physicians’ offices, and/or insurance companies.
• Schedule patient tests and/or procedures in a prompt, courteous manner.
• Correctly utilize the Meditech system and accurately enter all mandatory information.
• Instruct patients and physician staff on authorization requirements, test preparation, and registration information.
• Establish and maintain a working knowledge and vocabulary of scheduled procedures.
• Demonstrate willingness and ability to process requests for diagnostic procedures and coordinate the Peer to Peer function as needed.
• Check patient orders for compliance with Medicare guidelines.
• Process physician’s orders in accordance with department standards.
• Assist with the orientation of new employees and serve as a resource within the department.
• Display confidence when processing difficult or interdepartmental requests.
• Be recognized by customers as knowledgeable and helpful.
• Manage daily operations including Meditech, Orders Management System, Call Center Equipment (phones, etc.), and payer websites.

Requirements

• High school diploma or GED preferred.
• One year of precertification experience preferred.
• Previous Call Center Experience preferred.
• Meditech experience a plus.
• Wired High-Speed Internet with a minimum of 25 Mbps download and 15 Mbps upload required.
• Must live within 60 miles of an HCA hospital.

Benefits

Parallon offers a total rewards package that supports the health, life, career, and retirement of our colleagues. Available plans and programs include:

• Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health, and telemedicine services.
• Wellbeing support, including free counseling and referral services.
• Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage, and leaves of absence.
• Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support, and financial wellbeing counseling.
• Education support through tuition assistance, student loan assistance, certification support, dependent scholarships, and a partnership with Galen College of Nursing.
• Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection, and consumer discounts.

Note: Eligibility for benefits may vary by location.