This position is responsible for obtaining pre-certification and authorization from insurance companies needed for office procedures, hospital procedures, radiology orders and infusions.

ESSENTIAL FUNCTIONS:

1. Obtain insurance pre-certifications, authorizations for office procedures, hospital procedures, and radiology orders that require authorization.

2. Post authorizations in EPIC.

3. Assist staff with questions regarding pre-certs/authorizations/referrals.

4. Identifies and resolves prior authorization issues as it pertains to an authorization to ensure quality patient service.

5. Identifies and resolves if further investigation is needed, then advice appropriate staff of need for further investigation.

6. Obtain authorizations for procedures within 1-2 weeks of the scheduled procedure date; Obtain radiology authorizations within 7-10 days from when the radiology order was created.

7. Answers patient prior authorization questions that pertain to an authorization such as a denial or pending authorization.

8. Attend departmental and company-wide meetings as requested.

9. Perform other duties as assigned.

EDUCATION:  High School Diploma or equivalent preferred.

EXPERIENCE:  Minimum of six (6) months’ billing experience within a health care organization or pre-certification experience preferred.

TO APPLY, EMAIL YOUR RESUME TO HR@CHARLOTTEGASTRO.COM