Pratt Regional Medical Center
Pre-certification Specialist
Pratt Regional Medical Center - Pratt, Kansas, United States, 67124
Work at Pratt Regional Medical Center
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Overview
Pre-certification Specialist
Pratt-KS-67124-United States
Summary: The pre-certification specialist is responsible for obtaining prior authorizations for all procedural and ancillary orders by successfully completing the authorization process with all required payers. Job Duties: Review chart documentation to ensure patient meets medical necessity guidelines Prioritize incoming authorization requests according to urgency Obtain authorization via payer website or by phone and follow up regularly on pending cases Maintain current with payer requirements needed to successfully obtain authorizations Initiate appeals for denied authorizations Respond to clinic questions regarding payer medical necessity guidelines Confirm accuracy of CPT and ICD-10 diagnoses in the procedure orders Compensation & Benefits:
Competitive wages and excellent fringe benefit program. Salary commensurate with experience.
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Pratt-KS-67124-United States
Summary: The pre-certification specialist is responsible for obtaining prior authorizations for all procedural and ancillary orders by successfully completing the authorization process with all required payers. Job Duties: Review chart documentation to ensure patient meets medical necessity guidelines Prioritize incoming authorization requests according to urgency Obtain authorization via payer website or by phone and follow up regularly on pending cases Maintain current with payer requirements needed to successfully obtain authorizations Initiate appeals for denied authorizations Respond to clinic questions regarding payer medical necessity guidelines Confirm accuracy of CPT and ICD-10 diagnoses in the procedure orders Compensation & Benefits:
Competitive wages and excellent fringe benefit program. Salary commensurate with experience.
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