PCC Authorization Associate I

1 week ago


Atlanta, Georgia, United States Piedmont Healthcare Corporate Full time
Piedmont Healthcare Corporate is seeking a skilled professional to join our team as a PCC Authorization Associate I. In this role, you will be responsible for contacting insurance companies and other third-party payers to determine pre-certification, pre-authorization, and medical necessity requirements for hospital outpatient visits. You will obtain pre-certification or pre-authorization prior to the scheduled service being performed and liaise with physicians and physician office staff to obtain additional demographic, insurance, or clinical information. Your attention to detail and strong communication skills will be essential in ensuring seamless interactions with payers and healthcare providers.

**Key Responsibilities:**

* Contact insurance companies and other third-party payers to determine pre-certification, pre-authorization, and medical necessity requirements
* Obtain pre-certification or pre-authorization prior to the scheduled service being performed
* Liaise with physicians and physician office staff to obtain additional demographic, insurance, or clinical information
* Notify the payer of admission if required

**Requirements:**

* High school diploma or GED
* Two (2) years of experience in Healthcare Revenue Cycle or related healthcare experience
* None

**Preferred Qualifications:**

* Three (3) years of previous related healthcare Revenue Cycle experience within precertification/authorization experience
* A Bachelor's degree from a recognized college or university
* Certification with Healthcare Financial Management Association, or Certified Revenue Cycle Representative
* Prior Epic experience
* Completion of medical coder training program

**Work Schedule:**

* Monday - Friday, 9:00am - 5:30pm

**Remote Work:**

* Yes

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