Precertification Representative PRN

Job Summary

The Precertification Representative is responsible for requesting, obtaining and following up on authorization requests. Requests and interdepartmental scheduling with minimal delay to customers. Correct utilization of all systems and accurately enters all mandatory information. Provides instructions to patients and physician’s staff on authorization requirements and information. Establish and maintain a working knowledge and vocabulary of scheduled procedures.

Responsibilities

• Requests, obtains and follows up on authorization requests
• Processes phoned and/or faxed requests processed in a prompt and timely manner
• Stat requests and interdepartmental scheduling processed promptly; Contacts the facilities, physicians’ offices and/or insurance companies to resolve denials/appeals
• Schedules patient tests, and/or procedures in a prompt, courteous manner; Correctly utilizes the features of the Meditech system and accurately enters necessary information; Instructs patients and physician staff on authorization, test preparation and registration information
• Establishes and maintains a working knowledge and vocabulary of procedures scheduled
• Demonstrates the willingness and ability to process requests for diagnostic procedures and coordinates the Peer to Peer function as needs arise
• Checks patient orders for compliance with Medicare guidelines
• Processes physician’s orders in accordance with department standards
• Aids in the orientation of new employees as needed and serves as a resource within the department
• Displays confidence when processing difficult or interdepartmental requests
• Recognized by customers as knowledgeable and helpful

Qualifications

• High school diploma or GED preferred
• One year of precertification experience preferred
• Previous Call Center Experience preferred
• Meditech experience a plus

Benefits

Work from Home, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The 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.

About the Role

This is a PRN position. Hours will vary. This Work from Home position requires that you live and will perform the duties of the position; within 60 miles of an HCA Healthcare Hospital (Our hospitals are located in the following states: FL, GA, ID, KS, KY, MO, NV, NH, NC, SC, TN, TX, UT, VA).