Central Intake Precertification Coordinator
Nexion affiliates operate skilled nursing and rehabilitation as well as assisted living facilities in Colorado, Louisiana, Mississippi and Texas. Each of our affiliate skilled nursing and assisted living campuses offers a home-like setting influenced by their own unique regional cultures. Our commitment to excellence is reflected in our positive clinical outcomes, resident and family member testimonials, satisfaction reports and AHCA Quality Awards.
This position will be responsible for making the outbound calls to all necessary private payors to verify benefit coverage and eligibility. This position will be responsible for providing accurate, timely and complete information for all resident admissions making the way for clean and accurate claims filing.
Experience in performing all aspects of insurance verification for Commercial Insurance
Efficient in acquiring information from medical providers and posting verified insurance information into systems for patient registration
Reviews for accuracy
Verifies all patient medical information and prior authorizations by calling primary, secondary and third party payers
Performs these tasks in a timely, efficient and error free manner
Performs telephonic support for online authorization of routine services
Provides direct support to facilities and care providers regarding utilization, authorization, and referral activities
Becomes proficient in the use of ICD-9 and CPT codes
Data entry referrals for services including inpatient and outpatient care
Contacts providers with authorization, denial, and appeals process information
Assists in educating and acts as a resource to primary care practices and specialty care providers
Provides precertification of members and participating network status of providers
Determines member benefit coverage requirements:
Requires 1 to 2 years of experience working in a medical office or hospital
Knowledge of Medical Insurances Required
At least one year of pre - cert experience, including navigating websites for online benefit reviews
Excellent computer, multi - tasking and phone skills
Ability to work well under pressure in a highly time-sensitive environment, be a team player and willing to perform diversified job duties
2+ years of recent high-volume pre - cert/insurance verification experience
High School graduate
We offer a great work environment, competitive compensation, and excellent benefits, which include: 100% Paid Vacation/Sick. Medical, Dental, Vision, 401k, FSA, ST and LT Disability, Life Insurance and AD and D.