Authorization Spec-Surg-Ancillary
$40,310–$40,310 year
On-siteFairhaven, Massachusetts, United States
Job Summary
Enter orders, schedule or cancel appointments, and determine patient liability by creating estimates based on individual payers. Initiate contact with patients, physicians, and third-party payers to obtain pre-certification and authorization for all inpatient and outpatient services. Liaise between payers and providers to coordinate peer-to-peer discussions for surgical and high-dollar services, while using critical thinking to ensure CPT codes are documented and authorized. Navigate multiple payer portals to submit electronic requests, work with pharmacy to obtain authorization for infusion medications, and follow up on denials by researching clinical data to support appeals. Verify coverage and initiate authorization for new patients accepted to the SE Rehab Department.
Required Qualifications
- Associates Degree in a related field or equivalent combination of education and experience
- Must be fully vaccinated against seasonal Influenza and the COVID 19 virus or to be exempt from the requirement for medical or personal reasons by signing a statement certifying you are choosing to be exempt from vaccination once hired
- MUST WORK ON MINOR HOLIDAY PER YEAR
Desired Qualifications
- Bachelors Degree
- Certificate in Medical Terminology
- Coding experience
- Strong keyboard skills with the ability to type 40 words per minute
- Proven exceptional customer service skills
- Ability to communicate with physicians, patients and third party payers
- Proficient with navigating multiple payer portals and web based tools
- Over three years of healthcare experience focusing on revenue cycle activities
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