Insurance Pre-Certification Coordinator
2 weeks ago
JOB SUMMARY:
The Insurance Pre-Certification Coordinator (Imaging) plays a crucial role in supporting our patients and clinical teams by leveraging their expertise in insurance pre-certification protocols while ensuring outstanding patient care.
KEY RESPONSIBILITIES:
1. Validate all patient demographic and insurance details, encompassing co-pays, deductibles, stop-loss amounts, guarantors, subscribers, and pre-certification prerequisites.
2. Timely update patient demographic and insurance records.
3. Acquire and assess Physician orders to ensure compliance with medical necessity coverage standards.
4. Investigate coverage criteria through interactions with insurance providers, medical literature, and compendiums to ascertain service eligibility promptly. Utilize various healthcare platforms and generate reports for appointment schedules.
ADDITIONAL DUTIES:
Other responsibilities may be assigned as needed, reflecting the dynamic nature of the role.
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