Medical Authorization Specialist

6 days ago


Huntington, West Virginia, United States Marshall Health Full time
Job Summary

We are seeking a skilled Precertification Representative to join our team at Marshall Health. As a key member of our healthcare team, you will be responsible for ensuring that patients receive the necessary authorization for their scheduled procedures.

Key Responsibilities
  • Authorization and Communication: Utilize electronic and manual systems to identify and capture source documentation needed for coding procedures, tests, and surgeries. Communicate with insurance carriers and other parties to facilitate prior authorization for scheduled procedures.
  • Precertification Process: Perform the precertification process for scheduled procedures, including communication of balances due to patients. Document details of procedure authorization, including approved CPT codes, diagnosis codes, and date of service ranges.
  • Backup and Support: Provide backup to clinics as needed and perform other duties assigned or requested.
Requirements
  • Education: Completion of a certification program such as Medical Assistant, Nurse Assistant, or equivalent required.
  • Experience: One year of billing or clinical experience in a healthcare organization is required.


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