- Preauthorization/Precertification 90%
A. Maintains Referral Queue, Referral/Precert task list, Worklist, and Financial Authorization task list within our Electronic Medical Record and Centricity Business system.
B. Contacts insurance companies to pre-certify inpatient and outpatient surgical procedures, Implanon and IUD insertions and maternity care.
C. Contacts patient insurance providers to verify benefits prior to the scheduled procedure and/or appointments.
D. Acts as a liaison between physician practice and third-party providers/facilities.
E. Corresponds with insurance companies and Medicare, as required to identify and collect the correct information for entry into the patient database for billing purposes.
F. Receives and responds to calls from patients regarding status of insurance claims, pre-certifications, authorizations, etc.
G. Responds to inquiries from physicians, nurses, hospitals, government agencies, insurance companies ,managed care companies and patients concerning requests for assistance to assure appropriate coverage for planned medical services.
H. Performs the duties of the financial counselor with regard to patient accounts in the case of scheduled time off or illness, or as requested.
I. Completes departmental FMLA and disability forms.
J. Works any reports deemed necessary for the area. (Ex. Ultrasound report, HMO Report, Molina report).
ll. Administrative
10%
A. Attend Training sessions, meetings and conferences and read publications to remain current on the policies and procedures of managed care/insurance companies.
B. Other duties/projects as assigned.
C. Ability to travel to all clinic locations.
SIU Medicine
$18.70 - $20.57 Hourly
medical insurance, dental insurance, life insurance, paid time off, paid holidays, sick time, extended sick time, tuition reimbursement, 403(b), retirement plan
Jan 21, 2025