OP Therapy Authorizations Rep
PARKVIEW HEALTH SYSTEM INC, Fort Wayne, IN, United States
Job Details
Location: Fort Wayne, IN
Company: Parkview Health
Department: System Therapy & Diagnostic Services
Position: Administrative Clerical
Schedule: Full Time, 7a-6p Flexible – Days
Hours: 40
Req #: 185433
Summary
The primary duty is to identify the patient’s insurance that requires pre-authorization for scheduled outpatient therapy and ensure it is obtained. The role includes accurately documenting pertinent authorization information in all related billing systems and performing benefit verification for identified services, communicating benefit details to the requesting department, and informing patients regarding lack of authorization or our out-of-network services. Responsibilities also involve evaluating each account individually, in a timely manner, to determine the appropriate pre‑certification requirements based on established criteria. This role is key to securing reimbursement and minimizing organizational write‑offs by following up on denials and appeals to obtain approval from insurance companies. Additionally, the individual may fill in as an Outpatient Therapy Scheduling Representative as needed.
Education
Must be a high school graduate or the equivalent with a GED. Medical terminology preferred.
Licensure / Certification
Addendums are required for 0153 Nurse Leader, 0249 Registry RN, 0252 Registered Nurse, 0235 Advanced Registered Nurse, and 0236 Expert Registered Nurse. To view addendums, go to the job description page on Parkview’s intranet.
Experience
Minimum of two years of experience in a health care setting, call center, or clerical position, including experience using Microsoft Office applications preferred. Registration experience preferred. One year of insurance pre‑authorization experience preferred.
Other Qualifications
Must have excellent verbal and written communication skills.
Must be able to demonstrate a working knowledge of general computer skills and applications.
Demonstrate ability to multi‑task and work independently using critical thinking skills.
Professional appearance and adherence to the clinic/facility dress code is expected.
Must be willing to work at other locations as assigned.
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Location: Fort Wayne, IN
Company: Parkview Health
Department: System Therapy & Diagnostic Services
Position: Administrative Clerical
Schedule: Full Time, 7a-6p Flexible – Days
Hours: 40
Req #: 185433
Summary
The primary duty is to identify the patient’s insurance that requires pre-authorization for scheduled outpatient therapy and ensure it is obtained. The role includes accurately documenting pertinent authorization information in all related billing systems and performing benefit verification for identified services, communicating benefit details to the requesting department, and informing patients regarding lack of authorization or our out-of-network services. Responsibilities also involve evaluating each account individually, in a timely manner, to determine the appropriate pre‑certification requirements based on established criteria. This role is key to securing reimbursement and minimizing organizational write‑offs by following up on denials and appeals to obtain approval from insurance companies. Additionally, the individual may fill in as an Outpatient Therapy Scheduling Representative as needed.
Education
Must be a high school graduate or the equivalent with a GED. Medical terminology preferred.
Licensure / Certification
Addendums are required for 0153 Nurse Leader, 0249 Registry RN, 0252 Registered Nurse, 0235 Advanced Registered Nurse, and 0236 Expert Registered Nurse. To view addendums, go to the job description page on Parkview’s intranet.
Experience
Minimum of two years of experience in a health care setting, call center, or clerical position, including experience using Microsoft Office applications preferred. Registration experience preferred. One year of insurance pre‑authorization experience preferred.
Other Qualifications
Must have excellent verbal and written communication skills.
Must be able to demonstrate a working knowledge of general computer skills and applications.
Demonstrate ability to multi‑task and work independently using critical thinking skills.
Professional appearance and adherence to the clinic/facility dress code is expected.
Must be willing to work at other locations as assigned.
#J-18808-Ljbffr