PRE AUTH SPECIALIST-CASE MGMT at Southwest General – Middleburg Heights, Ohio
Southwest General
Middleburg Heights, Ohio, 44130, United States
Posted on
Updated on
Job Function:Admin/Clerical/Secretarial
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About This Position
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POSITION INFORMATION
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Position summary:
- Contacts insurance companies and other third party payers to determine pre-certification, pre-authorization and/or medical necessity requirements for complex outpatient hospital services, and specialized procedures. Obtains pre-certification or pre-authorization prior to the scheduled service being performed. Liaisons with physicians and physician office staff including peer to peer when needed to obtain additional demographic, insurance or clinical information. Provides clinical support to Patient Connection Center Authorization and Prep Associates or as needed, any pre authorization necessary for any post-acute needs.
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Position summary:
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MINIMUM QUALIFICATIONS
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Education:
- Graduate of an accredited or NLN approved RN program. Bachelor’s degree preferred.
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Required length and type of experience:- Skill and ability in Microsoft Office applications. Strong clinical background and knowledge of patient care setting and clinical practices.
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Required licensure, certification or registry:- Current Ohio RN license.
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Education:
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Job Location
Middleburg Heights, Ohio, 44130, United States
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