Pre-certification Coordinator 1
New
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The Ohio State UniversityHealthcare revenue cycle
Source API remote eligibility restrictions: United StatesFull-TimeEntry
Salary not disclosed
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Job Details
- Experience
- 6 months Relevant Experience
- Required Skills
- Microsoft Excel
Requirements
- Have a high school diploma or GED.
- Have 6 months of relevant experience in a healthcare setting, revenue cycle department, customer service, or authorization work in an insurance company, physician practice, or hospital.
- Medical terminology and payer requirements experience is preferred.
- Have experience with Windows, Excel, and intranet/internet navigation tools.
- Be able to work in multiple databases and software applications.
- Have experience using automated databases for management and reporting.
- Be able to work in a self-directed manner while interacting with consumers, physicians, and medical center faculty and staff.
- Be able to communicate clearly with the healthcare team.
Responsibilities
- Verify benefits for outpatient, inpatient, and ambulatory surgery services.
- Obtain prior authorizations for visits, procedures, and hospitalizations.
- Obtain pre-approvals, PCP referrals, and predeterminations for scheduled admissions, outpatient surgeries, and designated outpatient visits.
- Contact patients or families to determine demographic and insurance information needed for authorization processes.
- Inform patients of copays that will be due.
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