Insurance Pre Authorization Specialist at Good Shepherd Rehabilitation Network – Center Valley, Pennsylvania
Good Shepherd Rehabilitation Network
Center Valley, Pennsylvania, 18034, United States
Posted on
Updated on
Job Function:Medical
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About This Position
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JOB SUMMARY
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- Secure pre-authorization for inpatient IRF, Pediatrics, and LTACH admissions
- Facilitate peer to peer and/or family appeals when needed
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ESSENTIAL FUNCTIONS
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- 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
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QUALIFICATIONS:
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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.
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Education
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- High School diploma required
- Associates degree preferred
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Work Experience
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- 1-2 years in health insurance authorization process (hospital experience) preferred
- Previous call center experience or similar, high volume environment preferred
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Licenses / Certifications
- N/A
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Education
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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.
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Job Location
Center Valley, Pennsylvania, 18034, United States
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