Care Authorization & Precertification Specialist

Arkansas Heart Hospital; United States; On-site; USD 42,000 - 64,000; Full time

Job summary

Arkansas Heart Hospital is seeking a Precertification Specialist to obtain and complete insurance precertifications and authorizations for clinical procedures. The role requires coordinating with insurance companies, patients and clinical staff to gather information and determine necessity.

You will maintain accurate documentation in patient records, develop relationships with physicians and insurance providers, and apply proper medical terminology and CPT codes in collaboration with coding

Qualifications

• High school diploma or equivalent required.
• Associate of Science preferred.

Responsibilities

• Obtain and complete all insurance precertification and authorizations for various clinical procedures.
• Determine the necessity for precertification and coordinate with insurance companies and clinical staff to obtain information.
• Maintain complete and accurate documentation within the patient medical record.
• Maintain proficiency in insurance requirements, medical terminology, and medical necessity related to clinical procedures.
• Use clinical documentation to obtain appropriate CPT codes for procedures from coding staff as necessary.
• Demonstrate time management and prioritization to complete urgent precertification/authorization requests.
• Maintain knowledge of certification/referral workflow.
• Develop and maintain relationships with physicians, medical staff, and insurance companies.

Skills

Medical terminology

Time management

Communication with insurers

Documentation

Education

High school diploma or equivalent

Associate of Science

Job description

Arkansas Heart Hospital is seeking a Precertification Specialist to obtain and complete insurance precertifications and authorizations for clinical procedures. The role requires coordinating with insurance companies, patients and clinical staff to gather information and determine necessity.

You will maintain accurate documentation in patient records, develop relationships with physicians and insurance providers, and apply proper medical terminology and CPT codes in collaboration with coding