Nurse (Consultant/Third-Party Collections)

1 week ago


Bethesda, United States Military Treatment Facilities Under Dha Full time

Collaborate with health insurers to provide information such as, patient status, reimbursement of funds, review and explanation of authorizations.
Communicate with Uniform Business office staff to assist in interpreting clinical information to over denials.
Communicate with insurance companies, patients and other interested parties regarding approvals/denials and appeals.
Review daily admission reports and provide pre-certification information as required.
Provide case specific clinical documentation to insurance providers for initial and/or continued stay.
Perform concurrent utilization review and communicate with insurance carrier on continued stay.
Schedule peer to peer request between healthcare providers.
Complete authorization of retroactive third-party insurance claims.
Correspond in writing, and via phone, with insurance companies, patients, and other interested parties regarding approval/denial of bills.


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