The Pre-Authorization Specialist is responsible for providing accurate and complete data input for DME precertification/preauthorization requests while providing highest level customer service to all contacts.
Duties include but are not limited to:
- Respond to calls from physician offices, hospitals, patients and insurance companies
- Review and match structured clinic data against medical terms and diagnosis/procedure codes while following established procedures for authorizing requests
- Attach incoming information to EMR/PM claims and follow established procedures for distributing information for further review
- Call back providers with precertification numbers as needed and file completed precertification requests as directed
- Contact hospitals for discharge dates as needed
- Refer callers to appropriate benefit departments when requests are made for additional benefit information
- Maintain patient confidentiality as defined by state, federal, and company regulations
- Establish effective rapport with other employees, professional support staff, customers, clients, families, and physicians
- Maintain cooperative working relationships with all departments and providers
- Support company and departmental QA/QI initiatives
- Perform other duties and assist with special projects as assigned
Requires a high school diploma and 1-3 year hands-on experience in prior authorizations particularly in DME or rehabilitation. Additional education in the form of an Associate’s or Bachelor’s degree is preferred. Must have excellent communication and organizational skills. Demonstrated proficiency in keyboarding /computer use is required. The ideal candidate will be self-motivated and able to work effectively in an independent environment. High level customer service skills and the ability to deal effectively with emotionally charged situations is essential to success. Must be available for scheduled shifts which includes arriving promptly and completing shifts as needed to meet demands of daily call levels. Requires strong organizational and task prioritization skills combined with an eye for detail. Familiarity with medical terminology or willingness to learn is key.
All applications MUST be submitted via our website.
CU Medicine is dedicated to ensuring a safe and secure environment for our staff and visitors. To assist in achieving that goal, we conduct background investigations for all prospective employees prior to their employment. Additionally, drug and health screenings may be required for some positions. We are an equal opportunity employer.
CU Medicine supports a Tobacco Free Workplace Environment which prohibits smoking and the use of tobacco products on CU Medicine property, Anschutz Medical Campus and adjacent business locations.
- Pay Type Hourly
- Required Education High School
- 12631 E 17th Ave, Aurora, CO 80045, USA