Preauthorization Representative - REMOTE

AH_001 Arnot Ogden Medical Center; United States; Remote; USD 24,000 - 28,000; Full time

Job summary

Arnot Health is seeking a Pre-Authorization/Pre-Certification Clerk to join our team. This role supports hospital services by pre-authorizing outpatient exams and coordinating with departments and insurers to secure approvals.

The ideal candidate will have ICD9/CPT coding familiarity, strong organizational and communication skills, and a high school diploma or equivalent. This position reports to the Pre-Authorization Supervisor and offers competitive pay and benefits.

Qualifications

• Clinical experience in various areas is needed/and or coding in various areas.
• Good organizational, communication, and customer relations skills.
• ICD9/CPT coding certifications or prior billing experience.
• High School diploma or equivalent experience required.

Responsibilities

• Pre-authorize / pre-certify patients’ exams for all departments to ensure smooth daily operation.
• Check appointment schedules daily to ensure all admissions and procedures have been approved by the insurance carrier.
• Conference with other departments to resolve pre-authorization problems.

Skills

Clinical experience

Communication

Customer service

ICD9/CPT coding knowledge

Education

High School diploma or equivalent

ICD9/CPT coding certifications

Job description

About Arnot Health

Arnot Health offers patient-centered, comprehensive health services to the Southern Tier of New York and Northern Tier of Pennsylvania. Campuses include Arnot Ogden Medical Center and St. Joseph's Hospital in Elmira; Ira Davenport Memorial Hospital in Bath, NY; and over 40 medical offices in the Southern Tier. Arnot Health is currently affiliated with more than 300 physicians from 50+ specialties. Arnot Health is a member of Centralus Health, a community-based integrated delivery system. Our mission is to deliver high-quality care, empower our teams to succeed, and improve the wellbeing of the communities we serve. Our commitment to quality personalized care begins with our exceptional team—over 6500 employees strong. At Arnot Health, you will work in a collaborative environment that values excellence, integrity, compassion and stewardship. Together, we create an environment where empathy, honesty and a dedication to quality thrive, empowering us to make a positive impact on the lives we touch. We offer competitive wages, comprehensive benefits, and professional development opportunities to help our employees grow and thrive. Whether you are just starting your career or taking the next step in healthcare, we invite you to join us in shaping the future of care in our communities. Learn more at www.arnothealth.org.

Summary

Works within a team environment pre-authorizing out patient exams for various hospital services. This position will require a degree of complexity and prior anatomy education. Reports directly to the Pre-Authorization Supervisor.

Roles and Responsibilities

COMMUNICATION

• Promptly answers the telephone in a professional and courteous manner.
• Demonstrates the knowledge and ability to utilize various computer networks and telephone applications to procure pre-authorizations for patients.
• Demonstrates the ability to complete pre-authorizations in a timely manner.
• Demonstrates the ability to communicate courteously and effectively with internal and external customers.
• Demonstrates an understanding of both CPT, ICD9 and medical terminology.
• Demonstrates the ability to check appointment schedules daily to ensure that all admissions and procedures have been approved (pre-authorized) by the insurance carrier.

CLERICAL

• Demonstrates insurance knowledge.
• Demonstrates knowledge of ICD-9 coding / CPT / HCPCs to ensure Arnot Health to receive the maximum reimbursement that is allowable.
• Demonstrates knowledge of Medicare requirements for approved ICD-9 codes and to communicate to the provider when a code is not approved, and knowledge of Medicare waivers.
• Demonstrates the ability to accurately pre-authorize / pre-certify patients exams for all departments to ensure the smooth daily operation of the department.
• Has knowledge of the method of proper sequencing of exams (ie. prioritization).
• Communicates all questions to the appropriate department.
• Has ability to conference with other departments to bring about conflict resolution to pre-authorization problems.
• Demonstrates the ability to be cross-trained to other responsibilities of the department as required by the Supervisor/Director.

Required Skills and Experience

• Clinical experience in various areas is needed/and or coding in various areas.
• Good organizational, communication, and customer relations skills.
• ICD9/CPT coding certifications or prior billing experience.
• High School diploma or equivalent experience required.

Preferred Skills and Experience

Hospital experience and service oriented experience.

Physical Requirements

Light physical effort. Typical office job.

Pay Range Disclosure

Standard Rate of $17.20 - $20.33 per hour plus benefits.

Equal Employment Opportunity

Centralus and its affiliates are committed to treating all patients, providers, staff and volunteers equitably and with dignity, ensuring the highest levels of safety, care and respect, and striving to recognize and overcome biases and policies that contribute to disparities in healthcare access, equitable care and positive health outcomes for all.

We are proud to be an Equal Employment Opportunity employer, supporting the growth and health of our employees and community by embracing the rich diversity, needs and circumstances of all peoples and prioritizing opportunities to build a diverse and inclusive workplace.

We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable protected characteristics.

If you require reasonable accommodation to complete a job application, pre-employment testing, a job interview or to otherwise participate in the hiring process, please contact the Centralus Talent Acquisition team at [e-mail].

We're excited you're considering joining our team. At Centralus Health, we foster a culture of care, trust, and belonging. Here, you’ll have the opportunity to grow and thrive in your career while making meaningful connections with patients, families, colleagues, and communities.