Precertification Representative PRN

Description

This Work from Home position requires that you live within 60 miles of an HCA Healthcare Hospital (states include FL, GA, , KS, KY, MO, NV, NH, NC, SC, TN, TX, UT, VA).

Parallon offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

• Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free Air Med medical transportation.
• Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long‑term care coverage, moving assistance, pet insurance and more.
• Free counseling services and resources for emotional, physical and financial wellbeing.
• 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service).
• Employee Stock Purchase Plan with 10% off HCA Healthcare stock.
• Family support through fertility and family building benefits with Progyny and adoption assistance.
• Referral services for child, elder and pet care, home and auto repair, event planning and more.
• Consumer discounts through Abenity and Consumer Discounts.
• Retirement readiness, rollover assistance services and preferred banking partnerships.
• Education assistance (tuition, student loan, certification support, dependent scholarships).
• Colleague recognition program.
• Time Away From Work Program (paid time off, paid family leave, long‑ and short‑term disability coverage and leaves of absence).
• Employee Health Assistance Fund that offers free employee‑only coverage to full‑time and part‑time colleagues based on income.

Learn more about Employee Benefits ()

Note:

Eligibility for benefits may vary by location.

We are seeking a Precertification Representative for our team to ensure that we continue to provide all patients with high quality, efficient care. We want you to apply!

The Precertification Representative is responsible for requesting, obtaining and following up on authorization requests, maintaining minimal delay to customer, correctly utilizing all systems, entering mandatory information accurately, providing instructions to patients and physician staff, and establishing a working knowledge of scheduled procedures. This role manages daily operations including Meditech, Orders Management System, Call Center Equipment, and payer websites.

• Request, obtain and follow up on authorization requests.
• Process phoned and/or faxed requests promptly and accurately.
• Process stat requests and interdepartmental scheduling promptly.
• Contact facilities, physicians’ offices and/or insurance companies to resolve denials and appeals.
• Schedule patient tests and/or procedures in a prompt, courteous manner.
• Correctly utilize the features of the Meditech system and accurately enter necessary information.
• Instruct patients and physician staff on authorization, test preparation and registration information.
• Maintain a working knowledge and vocabulary of scheduled procedures.
• Process requests for diagnostic procedures and coordinate the Peer‑to‑Peer function as needed.
• Check patient orders for compliance with Medicare guidelines.
• Process physician orders in accordance with department standards.
• Assist with orientation of new employees and serve as a resource within the department.
• Display confidence when processing difficult or interdepartmental requests.
• Be recognized by customers as knowledgeable and helpful.

• High school diploma or GED preferred.
• One year of precertification experience preferred.
• Previous call‑center experience preferred.
• Meditech experience a plus.
• Virtual employees are required to have wired high‑speed Internet (25 MBS download and 15 MBS upload).
• Remote employees are required to live within 60 miles of an HCA hospital.

Parallon () provides full‑service revenue cycle management for HCA Healthcare, including scheduling, registration, insurance…