Pre-Authorization Specialist

Job description

Pre-registers patients for hospital surgical and ancillary services to include insurance eligibility verification, benefit and out of pocket liability determinations, pre-determination and pre-certification / authorization of surgeries and/or other clinical services performed at BTNRH, or on behalf of a BTNRH provider. Communicates benefits and liabilities to patients while working to set up reasonable payment accommodations or collecting in advance of services rendered and refers patients to Patient Financial Counseling services when necessary. SCHEDULE: Youth Care Building (140th & Pacific). Monday-Friday 8:30a-5p. MAJOR RESPONSIBILITIES & DUTIES: Maintains excellent communication and positive rapport with all points of contact both internally and externally, documenting pertinent discussions and details of correspondence in all applicable systems to provide tracking and point of reference. Responsible for obtaining and communicating accurate benefit information and eligibility, pre-determination/pre-authorization as well as detailed benefit and patient liabilities per insurance company requirements and established timeframes, i.e., online vs. telephone to ensure credible coverag...