• Pre-Authorization Clerk

    Posted: 11/13/2022

    Pre-Authorization Clerk
    St. Margaret’s Health – Peru
    Full Time
    Monday through Friday, Days
     
    Scope of Responsibility:
    Responsible for contacting payers by phone or online for patient benefits and pre-certification/authorization for outpatient services; Coordinate information with physician offices and internal departments pertaining to pre-certification/authorization of services. Knows Medical Terminology and ability to read physician charting and communicate information to insurance company. Responsible for verifying that physician orders are complete and that the diagnosis provided and the testing ordered meet Medicare’s Local Coverage Determinations and/or private insurance requirements prior to services being performed; Knowledge of scheduling process and procedures; Able to utilize resources for coding procedures and diagnosis; perform follow up on pending authorization; accurately performs mandatory documentation of approval or denial of procedure and notify scheduling of outcome.
     
    Education Requirements:
    Minimum high school diploma or equivalent.

    Click here for more information on how to apply.