Insurance Authorization and Scheduling Specialist - Appalachian Regional Healthcare : Job Details

Responsible for coordinating with insurance providers for verification, pre-certification, pre-authorizations, and pre-determination for medical procedures within respective or designated service lines in the ARH System. Completes benefits review and prior authorizations as required by all payers for scheduled services. The Preauthorization Coordinator interfaces with clinical staff, payer representatives, and patients, daily, to review scheduled services and to ensure complete and accurate information is documented. This role completes necessary clinical review for prior authorizations as required by governmental and commercial payers, satisfying maximum net revenues and minimum avoidable losses for authorizations. Responsibilities - Ensures that patient demographic, insurance information, verification and eligibility have been established and documented. - Verifies pre-certifications and obtains upgrades if needed - Coordinates rescheduling in the event that prior-authorization is no...Insurance, Authorization, Specialist, Scheduling, Healthcare, Business Services