Pre-Authorization Representative

Position Summary

Under direction, is responsible for the management of insurance verifications, eligibility and prior authorizations for activities requiring referrals, which may include surgical procedures, visits and/or diagnostic testing

Job Responsibilities

• Verifies pre-certifications and obtains upgrades if needed. If pre-certification is not obtained for next day, notifies the referring doctor's office and contacts the patient to find out if they would rather reschedule.
• May be required to greet patients in person and notify clinical staff of arrival.
• Responsible for mail services, photocopying, scanning and filing.
• Verifies patient insurance eligibility and obtains necessary pre-authorization numbers, if required, prior to appointment date. Facilitates the communication and collection of any fees due from patient.
• Initiates and prepares written correspondence as needed and based on functional needs.

Education

High school diploma or GED

Experience

Approximately 1 year of prior related experience in a customer service focused role.

Knowledge, Skills and Abilities

Demonstrated strong organizational skills and ability to pay close attention to detail.

Working Conditions/Physical Demands

Standard office work