Central Intake Precertification Coordinator

Nexion Health Dallas , TX 75201

Posted 2 months ago

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.

RESPONSIBILITIES:

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.

ESSENTIAL FUNCTIONS:

  • 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:

QUALIFICATIONS:

  • 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.

EOE M/F/D/V


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Central Intake Precertification Coordinator

Nexion Health