|Title:||Pre-Authorizations/Referrals Specialist | $18.00/Hr. - Immediate!|
|Location:||Mission Hills, CA 91345|
|Compensation:||$18.00 - $19.00|
Demonstrates competency and knowledge in HMO/EPO/PPO eligibility and benefit coverages. Serves as a liaison between patients, hospitals, and health plans. Responsible for verification of eligibility and benefits for managed care members.
PRIMARY DUTIES & RESPONSIBILITIES:
- Handle Authorization submissions and follow ups for all Insurance Payors including Medicare, Medicaid’s, HMO and PPO’s
- Complete and thoroughly document all Accounts
- Ensure that all assigned Authorizations are resolved within appropriate time restraints
- Research, follow-up, and resolve all open/pending Authorizations in a timely manner
- Contact Payors for status of outstanding/pending Authorization requests
- 2 years’ experience in a clinic, hospital or related health care industry in a managed care environment, or equivalent in education or medical certification in medical field (i.e. nursing, medical billing and coding, or medical admin assisting).
- Knowledge of HMO/EPO/PPO insurance processing, ICD-9 and 10/CPT coding and medical terminology