Cardiac Precertification Coordinator

Nezda Technologies, Inc.; Metro Manila; On-site; PHP 558,000 - 1,451,000; Full time

Job summary

Nezda Technologies, Inc. seeks a Precertification Coordinator to secure and coordinate prior authorizations and referrals for cardiac procedures, including Cardiac Cath and Cardiac EP, for both inpatient and outpatient services.

The role requires 1 year bedside experience and 3 years of CDI or coding experience. Onsite work in Ortigas is expected, with multiple salary tiers based on licensure: USRN with coding and PHRN licenses, or USRN alone, or PHRN.

Qualifications

• USRN, coding license and PHRN license required.
• Active USRN license and minimum 2 years bedside experience for USRN track.
• Active PRC license and minimum 1 year bedside experience for PHRN track.

Responsibilities

• Coordinate prior authorizations and referrals for cardiac procedures for inpatient and outpatient services.
• Prioritize authorization requests by urgency and queue requirements.
• Review clinical records and supporting documentation related to requested services.
• Process, obtain and follow up on authorizations with payers via calls, portals or fax.
• Coordinate payer-required peer-to-peer reviews and communicate requirements to the provider.

Skills

USRN license

Coding license

PHRN license

Bedside experience

CDI experience

Job description

Nezda Technologies, Inc. seeks a Precertification Coordinator to secure and coordinate prior authorizations and referrals for cardiac procedures, including Cardiac Cath and Cardiac EP, for both inpatient and outpatient services.

The role requires 1 year bedside experience and 3 years of CDI or coding experience. Onsite work in Ortigas is expected, with multiple salary tiers based on licensure: USRN with coding and PHRN licenses, or USRN alone, or PHRN.