Lead Precertification Specialist

Medical University of South Carolina

  • Charleston, SC
  • 30+ days ago
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    Skills

    • Contract Requirementsunmatched
    • Documentationunmatched
    • Federal Laws and Regulationsunmatched
    • Hospitalunmatched
    • Medical Recordsunmatched
    • Outpatient Careunmatched
    • Patient Careunmatched
    • Patient Care Authorizationsunmatched
    • State Laws and Regulationsunmatched
    • Third-Party Payerunmatched
    • Time Managementunmatched

    Description

    Job Description Summary

    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.

    Entity

    Medical University Hospital Authority (MUHA)

    Worker Type

    Employee

    Worker Sub-Type

    Regular

    Cost Center

    CC002349 CHSCorp - Precertification Unit

    Pay Rate Type

    Hourly

    Pay Grade

    Health-20

    Scheduled Weekly Hours

    40

    Work Shift

    Job Description

    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 individual 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.

    Additional Job Description

    Education: High School Degree or Equivalent Work Experience: 1 year

    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

    Numbers & Facts

    LocationCharleston, SC

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