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Insurance Pre Authorization Specialist in Center Valley, Pennsylvania at Good Shepherd Rehabilitation Network

Job Function: Medical
Good Shepherd Rehabilitation Network
Center Valley, Pennsylvania, 18034, United States
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Job Description

  • JOB SUMMARY
      • Secure pre-authorization for inpatient IRF, Pediatrics, and LTACH admissions
      • Facilitate peer to peer and/or family appeals when needed
  • ESSENTIAL FUNCTIONS
      • Secures necessary pre-authorization in an accurate and timely manner
      • Acts as a patient advocate between the patient and insurance company
      • Communicates authorization status clearly to Clinical Liaison and office team
      • Maintains authorization work lists in Cerner
      • Research denials due to authorization or referral issues and determine cause and resolution, re-submits claims when appropriate after gathering necessary information
      • Recognizes time sensitivity of completion of cases and commits to daily completion
      • Answers patients’ calls regarding authorization questions
      • Must be deadline driven, sense of urgency and collaborative to prevent delays in admission
      • Contributes to a positive work environment
      • Contributes to the overall team efforts
  • QUALIFICATIONS:
    • To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
      • Education
          • High School diploma required
          • Associates degree preferred
      • Work Experience
          • 1-2 years in health insurance authorization process (hospital experience) preferred
          • Previous call center experience or similar, high volume environment preferred
      • Licenses / Certifications
        • N/A

Job Location

Center Valley, Pennsylvania, 18034, United States

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