At UK King's Daughters, we're not just a healthcare facility — we're a family of dedicated professionals who share a passion for making a meaningful difference in the lives of our patients. We're more than just a place to work; we're a place to grow, thrive, and contribute to our community.

Job Description :

Job Summary Responsible for providing entry-level support in the enterprise contact center to ensure accurate, timely, and professional service. Aids with appointment scheduling and routine inquiries under established procedures. Ensures compliance with organizational policies, payer requirements, and confidentiality standards. Coordinates with team members and supervisors to resolve basic issues and contribute to a positive patient experience. Essential Functions

• Tracks, obtains, and extends authorizations from insurance carriers.
• Records and documents insurance information throughout the pre-certification and prior authorization process.
• Maintains and utilizes electronic medical records and relevant databases independently.
• Obtains, interprets, and submits clinical documentation required for prior authorization reviews.
• Communicates authorization status and delays professionally to physicians and clinical staff.
• Follows up on denied authorization requests and facilitates appeals or peer-to-peer reviews.
• Supports claim submission and denial appeal efforts by clarifying authorization details.
• Resolves claim denials related to the prior authorization process through account and claim review.
• Verifies primary insurance payer for new admissions.
• Contacts insurance payers to obtain visit authorizations.
• Performs audits of referral and payer source information.
• Consults with Intake RN and leadership to gather necessary information for payers.
• Provides required information to insurance and payer sources.
• Assist team members with questions on claim denials.
• Performs other duties as assigned.

Education Requirement:

High school diploma or equivalent

Experience Requirement:

0-2 years of experience in health information management, or related healthcare role An equivalent combination of education and experience may be considered. All experience must be paid and in the same related field. Part-time and PRN experience will be prorated based on hours worked per week. Volunteer work and internships for academic credit are not counted.

Certifications & Licensures:

N/A Working Conditions A. Lifting, pushing, and/or pulling objects up to 50lbs:2. Occasional (< 10% of the time) B. Lifting, pushing, and/or pulling objects over 50lbs:1. Never C. Standing or walking with objects up to 10lbs:3. Intermittent (10%

• 50% of the time) D. Standing or walking with objects up to 25lbs:2. Occasional (< 10% of the time) E. Sitting at the computer workstation for extended periods:3. Intermittent (10%
• 50% of the time) F.

Risk of back injury from moving, lifting or positioning patients, equipment, or materials:2. Occasional (< 10% of the time) G.

Repetitive motion:

3. Intermittent (10%

• 50% of the time) H.

Working at heights above 4 feet:1. Never I.

Working in confined spaces:

1. Never J. Risk of injuries from use of equipment on the job:2. Occasional (< 10% of the time) K.

Job-related travel:

2. Occasional (< 10% of the time) L.

Loud noises:

1. Never M.

Temperature extremes:

1. Never N. Hazardous chemicals and fumes including waste:2. Occasional (< 10% of the time) O.

Radiation:

1. Never P.

Burns:

1. Never Q.

Cuts/Punctures:

2. Occasional (< 10% of the time) R.

Bloodborne/airborne pathogens:

2. Occasional (< 10% of the time) S.

Recombinant DNA or viral vectors:

1. Never T.

Combative/violent people:

1. Never U. Animal handling (including carcasses):1. Never V. Please specify other(s) and amount of exposure (i.e. Occasional, Intermittent or Regular): N/A Physical Demands This position requires intermittent sitting at a computer workstation for extended periods of time; performing tasks with repetitive motions (such as typing); intermittent standing or walking with objects weighing up to 10 pounds; occasional standing or walking with objects weighing up to 25 pounds; and occasional lifting, pushing, or pulling objects weighing up to 50 pounds.

Department :

Home Health Shift :

Days (United States of America) (inactive)

Time Type :

Full time

Address :

2000

Ashland Drive City, State :

Ashland, Kentucky