MUSC Health
Precertification/Authorization Specialist-2
MUSC Health, Bluffton, South Carolina, United States, 29910
Overview
Responsible for verifying eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to the delivery of inpatient, outpatient, and ancillary services. This Specialist determines which patient services have third party payer requirements and is responsible for obtaining the necessary authorizations for care, via phone, fax, or payer websites. The Specialist provides detailed and timely communication to both payers and clinical partners in order to facilitate compliance with payer contractual requirements and is responsible for documenting the appropriate information in the patient\'s record. Other duties as assigned. Entity
Medical University Hospital Authority (MUHA) Worker Type
Employee Worker Sub-Type
Regular Cost Center
CC005693 CHS - Okatie Oncology (offsite) Pay Rate Type
Hourly Pay Grade
Health-20 Scheduled Weekly Hours
40 Work Shift
Responsibilities
Verify eligibility and obtain insurance benefits for patient services. Ensure pre-certification, authorization, and referral requirements are met prior to service delivery. Determine payer requirements for patient services and obtain necessary authorizations via phone, fax, or payer websites. Provide detailed and timely communication to payers and clinical partners to facilitate compliance with payer contracts. Document appropriate information in the patient’s record. Perform other duties as assigned. Qualifications
Education: High School Degree or Equivalent Work Experience: 1 year Additional Information
If you like working with energetic enthusiastic individuals, you will enjoy your career with us! The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need. Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here: http://www.uscis.gov/e-verify/employees Employment Type
Full-time Job Function
Other Industries
Hospitals and Health Care
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Responsible for verifying eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to the delivery of inpatient, outpatient, and ancillary services. This Specialist determines which patient services have third party payer requirements and is responsible for obtaining the necessary authorizations for care, via phone, fax, or payer websites. The Specialist provides detailed and timely communication to both payers and clinical partners in order to facilitate compliance with payer contractual requirements and is responsible for documenting the appropriate information in the patient\'s record. Other duties as assigned. Entity
Medical University Hospital Authority (MUHA) Worker Type
Employee Worker Sub-Type
Regular Cost Center
CC005693 CHS - Okatie Oncology (offsite) Pay Rate Type
Hourly Pay Grade
Health-20 Scheduled Weekly Hours
40 Work Shift
Responsibilities
Verify eligibility and obtain insurance benefits for patient services. Ensure pre-certification, authorization, and referral requirements are met prior to service delivery. Determine payer requirements for patient services and obtain necessary authorizations via phone, fax, or payer websites. Provide detailed and timely communication to payers and clinical partners to facilitate compliance with payer contracts. Document appropriate information in the patient’s record. Perform other duties as assigned. Qualifications
Education: High School Degree or Equivalent Work Experience: 1 year Additional Information
If you like working with energetic enthusiastic individuals, you will enjoy your career with us! The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need. Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here: http://www.uscis.gov/e-verify/employees Employment Type
Full-time Job Function
Other Industries
Hospitals and Health Care
#J-18808-Ljbffr