Preauthorization Representative

This is a fully remote position, open to applicants in New York.

📋 Description

• Collaborate with a team to pre-authorize outpatient examinations for a variety of hospital services.

• Report directly to the Pre-Authorization Supervisor.

• Respond to telephone inquiries in a professional and courteous manner.

• Utilize computer networks and phone applications to secure patient pre-authorizations.

• Complete pre-authorizations swiftly and accurately.

• Review daily appointment schedules to ensure admissions and procedures are authorized by insurance providers.

• Apply knowledge of insurance, ICD-9/CPT/HCPCS coding, Medicare regulations, and medical terminology.

• Pre-authorize and pre-certify patient examinations across various departments.

• Organize and prioritize work by sequencing exams effectively.

• Address inquiries to the relevant departments and assist in resolving pre-authorization issues.

• Cross-train for other departmental duties as necessary.

• Uphold computer security and engage in quality improvement monitoring and reporting.

• Collaborate with physicians, physician offices, and other healthcare team members.

• Execute additional tasks as assigned by the supervisor or manager.

• Adhere to standards of risk management, safety, emergency codes, confidentiality, professionalism, and customer service.

• Participate in staff meetings and mandatory annual educational sessions.

⛳️ Requirements

• Clinical experience in various domains and/or coding experience in multiple areas.

• Certification in ICD9/CPT coding or prior billing experience is necessary.

• A High School diploma or equivalent experience is required.

• Experience in a hospital setting is preferred.

• Strong organizational, communication, and customer relations abilities.

• Telephone etiquette is essential.

• Service-oriented experience is preferred.

• Familiarity with CPT, ICD-9, HCPCS, medical terminology, insurance, Medicare regulations, and Medicare waivers.

• Basic computer skills and the ability to navigate Arnot Health's computer system.

• Understanding of hospital departments and their interactions.

• Capability to maintain computer security and patient confidentiality.

• CPR certification is not required.

• Light physical effort; typical office job.

• Category III exposure classification.

🏝️ Benefits

• Annual mandatory educational programs.

• No CPR certification required.

• Fully remote work arrangement.