Determine hospital patients eligibility for service through pre-certification, prior authorizations and insurance verification.
ESSENTIAL DUTIES AND RESPONSBILITIES
- Verify patients eligibility of services.
- Determine if retroactive authorizations are required.
- Submit authorizations/follow-up requests to GA Medicaid.
- File written and verbal appeals, when required.
- Extensive knowledge and experience with GA Medicaid, billing and follow-up procedures.
- Ability to write clinicals and assessments after reviewing patient charts.
- 2+ years of experience in institutional billing/followup/precertifiations.
- Quick comprehension of processes and multiple insurance web-portals.
- Knowledge of HIPAA regulations.
- Use and knowledge of MS Office.
- Ability to work independently with minimal supervision.
- Minimum of 20 hours per week required.