Responsibilities
- Starts and manages the pre-determination workflow for surgical and nonsurgical procedures.
- Reaches out to relevant insurance providers to confirm patient benefits and secure pre-authorization; alerts financial counselors when advance payment is needed for services without set codes.
- Provides all necessary paperwork to insurers during the pre-certification review.
- Keeps an updated daily schedule of surgeries and procedures for department physicians; ensures consistent communication with medical providers and their support staff about scheduling.
- Tracks all active pre-certification requests in a written record; informs hospital utilization and billing teams once pre-authorization is secured.
- Records confirmation details when insurance companies approve pre-certification.
- Completes additional assigned tasks as needed.
Work Arrangement
Remote
