Precertification Coordinator Team Lead Full Time
Summary
| Title: | Precertification Coordinator Team Lead Full Time |
|---|---|
| ID: | 1655 |
| Department: | Administration |
| Job Locations: | Nashville South--Harding Place TN |
Description
The Hughston Clinic, The Hughston Foundation, The Hughston Surgical Center, Hughston Clinic Orthopaedics, and Jack Hughston Memorial Hospital participate in E-Verify. This company is an equal opportunity employer that recruits and hires qualified candidates without regard to race, religion, color, sex, sexual orientation, gender identity, age, national origin, ancestry, citizenship, disability, or protected veteran status. This company is a VEVRAA Federal Contractor.
Position Goal: Complete the precertification and prior authorization process by calling insurance companies, adjusters, and patients. Communicate the approval or denial of surgeries and/or tests effectively to physicians, physicians’ staff, and patients. Coordinate and provide coverage for all precertification staff throughout the HCO organization.
Position Responsibilities:
- Responsible for obtaining precertification and prior authorization for patients scheduled for a surgical procedure and/or tests as ordered by physician
- Responsible for obtaining all necessary information required to obtain precertification or prior authorization to include clinical dictation and test results
- Provide accurate information to insurance companies based on test results, clinical dictation, etc.
- Verify/re-verify insurance benefits and eligibility for each scheduled surgical procedure and/or test
- Complete precertification and prior authorization process in a timely, efficient manner with respect to urgent requests
- Collect any patient responsible payments for elective procedures and tests, as directed by Hughston policy
- Responsible to coordinate precertification and prior authorization activity through the HCO organization including providing coverage, staff training and cross-training, and direction to precertification team for all precerts and authorizations based on volume needs by location.
Education: High School Diploma or GED.
Special Qualifications: Must be able to work independently and have a working knowledge of HIPAA.
*Travel Required*
This opening is closed and is no longer accepting applications
