Patient Access & Pre-Authorization Specialist

AdventHealth; Calhoun (GA); Presencial; USD 22.000 - 35.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Benefits from Day One

Paid Time Off from Day One

403-B Retirement Plan

4 Weeks 100% Paid Parental Leave

Career Development

Whole Person Well-being Resources

Mental Health Resources and Support

Pet Benefits

Descripción de la vacante

AdventHealth in Calhoun, GA is seeking a staff member to obtain prior authorization and pre-certification for services, ensuring medical necessity criteria are met. You will coordinate with the clinical team to align payer guidelines and support documentation processes.

The role involves documenting authorizations in EMR, communicating with physician offices, and verifying patient eligibility. A High School Diploma or GED is required to perform duties in a fast-paced healthcare setting.

Formación

• Validation is required.
• High school grad or equivalent required.
• GED acceptable as alternative.

Responsabilidades

• Obtains prior authorization or pre-certification of services for payment by insurance companies.
• Submits clinical documentation for approval to payors and ensures medical necessity criteria are met.
• Acts as liaison with the clinical care team to ensure payer guidelines compliance.
• Distributes information to ancillary departments and verifies eligibility and benefits as needed.
• Documents prior authorization information in EMR and communicates with physician offices regarding status.

Conocimientos

Validation

Educación

High School Grad or Equiv

GED

Descripción del empleo

AdventHealth in Calhoun, GA is seeking a staff member to obtain prior authorization and pre-certification for services, ensuring medical necessity criteria are met. You will coordinate with the clinical team to align payer guidelines and support documentation processes.

The role involves documenting authorizations in EMR, communicating with physician offices, and verifying patient eligibility. A High School Diploma or GED is required to perform duties in a fast-paced healthcare setting.