Medical Case Manager/Pre- Authorization Coordinator
3 weeks ago
THIS IS NOT A REMOTE POSITION
Position Purpose:
Work with patients and insurance companies to obtain prior authorizations for specific medical procedures as prescribed by medical staff. Responsible for keeping accurate records and authorization paperwork for each patient and provide documentation for insurance providers. Must be comfortable with talking with patients and customers on the phone. This position involves mostly on-phone work, in a call-center type environment, as well as photocopying/scanning/printing duties as needed.
Assist in monitoring utilization of medical services to assure cost effective use of medical resources through processing prior authorizations.
Initiate authorization requests for outpatient and inpatient services in accordance with the prior authorization list and coordinate Case management. Route to appropriate staff when needed.
Verify eligibility and benefits
Answer phone queues and process faxes within established standards
Data enters authorizations into the system.
Position Requirements:
Worker's Compensation Experience (preferred but not required)
Pre-Admission Experience
Patient Access Experience
Knowledge of CPT and ICD-10 coding.
Knowledge of EOB's
Team player
Reliable
Maintain strict confidentiality.
Work with spirit of teamwork and cooperation and with a commitment to constantly improving the work environment.
Education/Experience: High school diploma or equivalent. 3+ years of pre auth & customer service experience. Knowledge of medical terminology preferred.
Company DescriptionThe Reny Company is a rapidly growing health care cost containment company, helping clients save money and better navigate our changing health care system. We specialize in medical bill review and negotiation services for workers compensation, non-subscribers, third party administrators, and maritime clients.Company DescriptionThe Reny Company is a rapidly growing health care cost containment company, helping clients save money and better navigate our changing health care system. We specialize in medical bill review and negotiation services for workers compensation, non-subscribers, third party administrators, and maritime clients.-
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