Authorization Specialist Job at Baptist, Madison, OH

UFlrQnlCbENXOTU4Q04xNyt1M216ZTF6Z0E9PQ==
  • Baptist
  • Madison, OH

Job Description

Description

Job Summary

Coordinates precertification/authorization services for patients across the continuum of care promoting quality care and effective utilization of resources. Provides leadership when dealing with patient preauthorization functions including inpatient and outpatient services. Coordinates efforts between departments to ensure accurate precertification resulting in timely billing of claims. Some overtime and call back may be required. Performs other duties as assigned.

Responsibilities

  • Precertifies patient care services that require precertification in a timely efficient manner in order to optimize reimbursement for the patient as well as health care providers.
  • Communicates recommendations clinical information and fiscal information to appropriate internal and external customers in order to facilitate optimal delivery of services and customer satisfaction.
  • Reviews orders for accuracy and medical necessity to facilitate delivery of services and appropriate reimbursement.
  • Addresses issues identified with retrospective reviews for all payers.
  • All outpatient procedures will be timely precerted when applicable.
  • Works to improve the QI/PI process.
  • Assumes responsibility for personal growth and development by attendance and / or participation in inservices and continuing education programs.
  • Completes assigned goals.

Specifications

Experience

Minimum Required

  • 2 years of office and/or clinical experience.

Preferred/Desired

  • Prefer experience in a clinic setting as well as dealing with prior authorizations.

Education

Minimum Required

  • Knowledge of medical terminology

Preferred/Desired

  • Associates degree in related field

Training

Minimum Required

Preferred/Desired

Special Skills

Minimum Required

  • Advanced communication conflict management organizational and planning skills; advanced computer literacy skills.

Preferred/Desired

Licensure

  • LPN license

Minimum Required

Preferred/Desired

  • LPN

Required Experience:

IC

Job Tags

Full time, Work at office

Similar Jobs

innovitusa

Cloud Devops engineer Job at innovitusa

 ...Description The Cloud Specialist contractor supports the design, implementation, and operation of the agencys public cloud environment under the direction of the Public Cloud Specialist Team Lead. This role is responsible for deploying and maintaining cloud infrastructure... 

Cytel - USA & APAC

Senior Clinical Data Manager Job at Cytel - USA & APAC

 ...JOB DESCRIPTION The Senior Data Manager The Senior Data Manager brings advanced understanding of the clinical data management process from study start-up through database lock, including database design and data validation as per the requirements in the clinical... 

Northeast Healthcare Recruitment, Inc.

IFR Medical Helicopter Pilot - Housing Provided Job at Northeast Healthcare Recruitment, Inc.

Sign-OnBonus: Up to $100,000! We are seeking a Full-Time IFR Pilot to join ourHelicopter Air Ambulance operations based in Victoria, TX. This rolerequires commitment to safety, precision, and exceptional service during dayand night rotations in a 24-hour operation.... 

Confidential

A level Chemistry Teacher Job at Confidential

Department: International high school A level chemistry teacher for Aug, 2026, native speaker Responsibilities: 1. Obey Chinese basic laws and the regulations from school/Department. 2. Under the guidance of the development strategy of the international high school... 

BJC Healthcare

RN Case Manager Home Health Job at BJC Healthcare

 ...for eligible candidates Relocation available for eligible candidates *BJC Career Ladder Progression available: The BJC RN Career Ladder differentiates BJC as the place for nurses to work in the greater St. Louis area. This is a tool to empower nurses to...