Sr. Precertification Rep

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profile Job Location:

Philadelphia, PA - USA

profile Monthly Salary: Not Disclosed
Posted on: Yesterday
Vacancies: 1 Vacancy

Department:

Finance

Job Summary

Your Tomorrow is Here!


Temple Health is a dynamic network of outstanding hospitals specialty centers and physician practices that is advancing the fight against disease pushing the boundaries of medical science and educating future healthcare professionals. Temple Health consists of Temple University Hospital (TUH) Fox Chase Cancer Center TUH-Jeanes Campus TUH-Episcopal Campus TUH-Northeastern Campus Temple Physicians Inc. and Temple Transport Team. Temple Health is proudly affiliated with the Lewis Katz School of Medicine at Temple University.

To support this mission Temple Health is continuously recruiting top talent to join its diverse 10000 strong workforce that fosters a healthy safe and productive environment for its patients visitors students and colleagues alike. At Temple Health your tomorrow is here!

Equal Opportunity Employer/Veterans/Disabled

An Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation gender identity national origin or protected veteran status and will not be discriminated against on the basis of disability.

Your Tomorrow is Here!


Temple Health is committed to setting new standards for preventing diagnosing and treating major diseases in our community and across the nation. Achieving that goal means investing in our employees success through staff and leadership development. Our recruitment strategy is to attract and retain a diverse high performing workforce that fosters a healthy safe and productive environment for our patients and colleagues alike.

This position is responsible for obtaining and managing ongoing precertification/authorization for complex oncological hospital services. Responsible to coordinate peer to peer review and appeals of denials due to no authorization. Responsible to confirm the financial/insurance information obtained during the registration process to determine that State Federal and Third Party precertification/billing requirements are met to ensure optimal reimbursement for services to be rendered.

Education
Associates Degree in related field Required
Non Degree Program Graduate of an accredited LPN program Preferred or
Combination of relevant education and experience may be considered in lieu of degree Required

Experience
3 years experience in a pre-certification/utilization role Required
3 years experience in precertification processes for oncological or other specialized
medical services such as chemotherapy radiation oncology rehabilitation dialysis or
organ transplant Required

Licenses
PA Practical Nurse License Preferred
Cert Prof Utilization Review Preferred

Required Experience:

Senior IC

Your Tomorrow is Here!Temple Health is a dynamic network of outstanding hospitals specialty centers and physician practices that is advancing the fight against disease pushing the boundaries of medical science and educating future healthcare professionals. Temple Health consists of Temple University...
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Key Skills

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About Company

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Temple Health is a major Philadelphia-based academic health system that is driving medical advances through clinical innovation, pioneering research and world-class education.

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