Job Description Overview

JOB SUMMARY

This position is responsible for obtaining and/or verifying insurance precertification and prior authorization requirements for outpatient diagnostic and procedural services based on payer guidelines, hospital contracts, and applicable

CPT/HCPCS

codes. This role ensures all authorization requirements are identified, obtained, and acted upon within established timeframes to support timely patient care, accurate billing, and compliance with payer regulations. Responsibilities may be expanded, modified, or reassigned based on departmental needs and operational priorities. Responsibilities

ADDITIONAL SKILLS

Strong communication and customer service skills required. Ability to work independently. Able to perform several simultaneous tasks in an organized manner. Ability to process information quickly and accurately while in a stressful environment.

WORKING CONDITIONS

Centralized scheduling area. May be required to flex hours as the department demand shifts.

PHYSICAL REQUIREMENTS

Ability to communicate with other individuals; good visual acuity and manual dexterity; ability to perform repetitive tasks; ability to sit for long periods of time.

AGE GROUP SERVED

Young, middle and older adults.

ESSENTIAL EQUIPMENT

Able to operate and troubleshoot all department equipment properly and safely according to policy and procedure: fax machine, copier, personal computer, telephone and answering system, laser jet printer as well as any other applicable equipment not listed or as required. Qualifications

QUALIFICATIONS

The following or equivalents are the minimum requirements to perform the essential functions of this position:

EDUCATION

• Completion of High School or the equivalent
• Knowledge of medical terminology required
• Basic knowledge of computers required
• Previous healthcare or medical office experience required