Pre Auth Specialist-Case Mgmt

Middleburg Heights, OH - USA

Monthly Salary: Not Disclosed

Posted on: 3 days ago

Vacancies: 1 Vacancy

Job Summary

Summary

POSITION INFORMATION
- Position summary:
  - Contacts insurance companies and other third party payers to determine pre-certification pre-authorization and/or medical necessity requirements for complex outpatient hospital services and specialized procedures. Obtains pre-certification or pre-authorization prior to the scheduled service being performed. Liaisons with physicians and physician office staff including peer to peer when needed to obtain additional demographic insurance or clinical information. Provides clinical support to Patient Connection Center Authorization and Prep Associates or as needed any pre authorization necessary for any post-acute needs.
MINIMUM QUALIFICATIONS
- Education:
  - Graduate of an accredited or NLN approved RN program. Bachelors degree preferred.
- Required length and type of experience:
  - Skill and ability in Microsoft Office applications.
    Strong clinical background and knowledge of patient care setting and clinical practices.
- Required licensure certification or registry:
  - Current Ohio RN license.

Required Experience:

Summary POSITION INFORMATIONPosition summary:Contacts insurance companies and other third party payers to determine pre-certification pre-authorization and/or medical necessity requirements for complex outpatient hospital services and specialized procedures. Obtains pre-certification or pre-authori...