Current jobs related to Precertification Coordinator - Louisville - SENTA Partners
-
Precertification Specialist
2 days ago
Louisville, Kentucky, United States UofL Health Full timeAbout the RoleWe are seeking a highly skilled Precertification Specialist to join our team at UofL Health. As a key member of our organization, you will play a critical role in ensuring a positive patient experience by accurately and efficiently completing all necessary steps related to prior authorization, medical necessity determination, and financial...
-
ENT Precertification Specialist
2 days ago
Louisville, Kentucky, United States UofL Health Full timeAbout the RoleWe are seeking a highly skilled Precertification Specialist to join our team at UofL Health. As a key member of our healthcare team, you will play a critical role in ensuring a positive patient experience by accurately and efficiently completing all necessary steps related to prior authorization, medical necessity determination, and financial...
-
Precertification Specialist- ENT
2 months ago
Louisville, United States UofL Health Full timeOverview We are hiring at UofL Physicians for a Precertification Specialist- ENT Shift: 1st Shift Location:9931 Forest Green Blvd About Us UofL Physicians is one of the largest, multi-specialty physician practices in the Kentuckiana region. With over 700 providers, 200 practice locations and 78 specialties, UofL Physicians’ academic and community...
-
Utilization Management Coordinator
2 days ago
Louisville, Kentucky, United States Elevance Health Full timeJob Summary:Elevance Health is seeking a skilled Utilization Management Representative I to join our team. As a key member of our operations team, you will play a critical role in ensuring the smooth coordination of cases for precertification and prior authorization review.Key Responsibilities:Manage incoming calls and post-service claims work, providing...
-
Healthcare Operations Representative
2 days ago
Louisville, Kentucky, United States Elevance Health Full timeJob Summary:Elevance Health is seeking a skilled Utilization Management Representative I to join our team. As a key member of our operations team, you will play a critical role in ensuring the smooth coordination of cases for precertification and prior authorization review.Key Responsibilities:Manage incoming calls and post-service claims work, providing...
-
Clinical Services Specialist
2 days ago
Louisville, Kentucky, United States Elevance Health Full timeJob Summary:Elevance Health is seeking a skilled Utilization Management Representative I to join our team. As a key member of our operations team, you will play a critical role in ensuring the smooth coordination of cases for precertification and prior authorization review.Key Responsibilities:Manage incoming calls and post-service claims work, providing...
-
Utilization Management Representative I
4 weeks ago
Louisville, United States Elevance Health Full timeTitle: Utilization Management Representative I Location: This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of one of our PulsePoint locations. The Utilization Management Representative I will be responsible for coordinating cases for precertification and prior authorization review. How you will make an...
-
Utilization Management Representative I
4 weeks ago
Louisville, United States Elevance Health Full timeTitle: Utilization Management Representative I Location: This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of one of our PulsePoint locations. The Utilization Management Representative I will be responsible for coordinating cases for precertification and prior authorization review. How you will make an...
-
Insurance Authorization Coordinator
5 days ago
Louisville, Kentucky, United States Trilogy Health Services Full timeABOUT THE ROLE:This position is essential in supporting our mission at Trilogy Health Services. The Insurance Authorization Coordinator will play a pivotal role in managing prior authorizations, recertifications, and insurance verifications for prospective admissions and therapy services.Reporting to the Director of Payer Relations and Authorization...
-
Utilization Management Representative I
1 day ago
Louisville, United States Elevance Health Full timeTitle: Utilization Management Representative I Location: This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of one of our PulsePoint locations. The Utilization Management Representative I will be responsible for coordinating cases for precertification and prior authorization review. How you will make an...
-
Pre-Access Specialist
7 days ago
Louisville, United States UofL Health Full timeOverview: The Pre-Access Specialist will be responsible for verifying accurate insurance and demographic information, obtaining or verifying authorization, referrals or precertification, checking medical necessity, creating patient estimates and having financial clearance conversations with patients for outpatient procedures. The Pre-Access Specialist will...
-
Pre-Access Specialist
2 months ago
Louisville, United States UofL Health Full timeOverview: WE ARE HIRING! Location: 220 Abraham Flexner Way Louisville, KY 40202 About Us UofL Health is a fully integrated regional academic health system with seven hospitals, four medical centers, nearly 200 physician practice locations, more than 700 providers, the Frazier Rehabilitation Institute and the Brown Cancer Center. With more than 12,000 team...
Precertification Coordinator
1 month ago
Key Responsibilities:
1. Authorization Management:
- Obtain and verify pre-certifications or referrals for medical procedures, surgeries, and tests as required by insurance providers.
- Collaborate with physicians, nurses, and other clinical staff to gather necessary clinical information for precertification requests.
- Track and monitor pending authorizations and re-authorizations.
2. Communication:
- Serve as a liaison between the medical staff, billing department, and insurance companies.
- Communicate with insurance providers to ensure timely submission and approval of requests.
- Notify clinical staff and patients of any issues or denials.
3. Documentation:
- Maintain detailed records of all communications and authorization documents.
- Update patient files with relevant pre-authorization information.
- Ensure accurate entry of authorization details into electronic health records or other tracking systems.
4. Billing Support:
- Assist the billing department in resolving claim denials related to lack of authorization.
- Provide necessary documentation or clinical information to support appeals when necessary.
5. Regulatory Compliance:
- Stay updated with changes in insurance policies and governmental regulations pertaining to pre-authorization.
- Ensure processes and procedures are compliant with regulations and industry best practices.
6. Continuous Improvement:
- Monitor and analyze precertification process efficiency and recommend changes for improvement.
- Participate in training and professional development activities.
Qualifications:
- High school diploma required; Associate's or Bachelor's degree in a related field preferred.
- Experience in medical billing, insurance, or a related field.
- Familiarity with medical terminology.
- Strong organizational skills and attention to detail.
- Excellent communication skills, both verbal and written.
- Proficiency with electronic health record systems and office software.
