Precertification & Insurance Verification Team Member in Rolla, Missouri at Phelps Health
Job Function: Information Technology
Phelps Health
Rolla, Missouri, 65401, United States
Posted on
Explore Related Opportunities
Job Description
General Summary
- The Insurance Verification/Prior Authorization Team Member is responsible for verifying patient eligibility, determining benefits, and to obtain insurance prior authorization prior to patient’s exam date and time.
- Obtains or assists in obtaining prior authorization/precertification from insurance payers for surgical, laboratory, and diagnostic imaging procedures scheduled to be performed.
- Processes multiple patient prior authorization/precertification requests at any given time in an efficient and accurate manner. Documents prior authorization/precertification decisions following clinical policy in clinical software.
- Makes and receives calls on the status of authorizations and verifies benefits over the phone and/or via insurance payer websites.
- Confirms member Plan eligibility and benefits prior to processing a request for pre-certification. Utilizes clinical knowledge, clinical resources or clinical policy as required.
-
Education
- High school diploma or equivalent required. Graduate of a Registered Medical Assistant or Licensed Practice Nurse program preferred.
-
Work Experience- Minimum 1 year of clinical experience in a health care organization required. Experience in insurance verification and prior authorization process preferred. Knowledge of Medical terminology and CPT & ICD-9/10 codes preferred.
-
Certification/License N/A
- Ability to receive and express detailed information through oral communications, visual acuity, and the ability to read and understand written directions. Normal mental concentration with repetitive operations for a long period of time. Communicates well both verbally and in writing, creates accurate and punctual reports, shares information and ideas with others, has good listening skills. Ability to stand, walk, sit, and reach. Occasionally lifts and transports items weighing up to ten (10) pounds.
- Standard office conditions with more than average noise. Periodic contact with conditions such as fumes, noise, chemicals, hazards, and/or diseases.
Scan to Apply
Just scan this QR code to apply from your phone.
Job Location
Rolla, Missouri, 65401, United States
Frequently asked questions about this position
Similar Jobs In Rolla, Missouri
Bilingual Claims Representative
Aegis Administration LLC
Maryland Heights, Missouri
MO Onsite - Automotive Warranty Claims Adjuster
American Auto Shield
St. Peters, Missouri
Independent Field Auto Appraiser - St. Louis, MO
Property Damage Appraisers LLC
St. Louis, Missouri
Claims Director
McCarthy Building Companies, Inc.
St. Louis, Missouri
Continue to apply
Enter your email to continue. You’ll be redirected to the employer’s application.By clicking Continue, you understand and agree to JobTarget's Terms of Use and Privacy Policy.