Insurance Pre-Authorization Specialist

Cincinnati Children's Hospital Medical Center; United States; On-site; USD 26,000 - 32,000; Full time

Job summary

Cincinnati Children's South Campus is seeking a Pre-Authorization specialist to obtain approvals for scheduled services and medications using medical records and systems. You will verify insurance eligibility, coordinate referrals, and provide insurance estimates while adhering to registration workflows.

The role collaborates with Hospital Billing, Admitting, and Patient Financial Services to resolve issues, maintain accurate demographics, and support productivity standards in a fast-paced

Qualifications

• High school diploma or equivalent.
• No directly related experience.

Responsibilities

• Pre-Authorization: efficiently obtain pre-authorizations for scheduled services and medications using medical records and systems.
• Collaborate with internal and external resources on authorization scenarios.
• Contact families before scheduled visits to confirm insurance eligibility and referrals.
• Collect/provide insurance-based estimates and adhere to registration workflows.
• Maintain a general understanding of billing processes.
• Serve as a liaison between Hospital/Physicians Billing Service, Admitting, Outpatient Surgery, Outpatient Department, Patient Financial Services and other Cincinnati Children’s departments.
• Cross trained to work insurance pre-authorization for multiple divisions.
• Initiate calls to resolve issues and escalate system errors as needed.

Education

High school diploma or equivalent

Job description

Cincinnati Children's South Campus is seeking a Pre-Authorization specialist to obtain approvals for scheduled services and medications using medical records and systems. You will verify insurance eligibility, coordinate referrals, and provide insurance estimates while adhering to registration workflows.

The role collaborates with Hospital Billing, Admitting, and Patient Financial Services to resolve issues, maintain accurate demographics, and support productivity standards in a fast-paced