Precertification Representative

Introduction

This Work from Home position requires that you live and will perform the duties of the position; within 60 miles of an HCA Healthcare Hospital (Our hospitals are located in the following states: FL, GA, ID, KS, KY, MO, NV, NH, NC, SC, TN, TX, UT, VA).

Experience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career with an organization committed to delivering respectful, compassionate care, and where the unique and intrinsic worth of each individual is recognized. Submit your application for the opportunity below:Precertification RepresentativeWork from Home

Benefits

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 AirMed 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. Did you get into our industry for these reasons? We are an amazing team that works hard to support each other and are seeking a phenomenal addition like you who feels patient care is as meaningful as we do. We want you to apply!

Job Summary and Qualifications

The Precertification Representative is responsible for requesting, obtaining and following up on authorization requests. Requests and interdepartmental scheduling with minimal delay to customer. Correct utilization of all systems and accurately enters all mandatory information. Provides instructions to patients and physician’s staff on authorization requirements and information. Establish and maintain a working knowledge and vocabulary of scheduled procedures. Manage daily operations including but not limited to: Meditech, Orders Management System, Call Center Equipment (phones, etc.), payer websites.

In this role you will:

• Requests, obtains and follows up on authorization requests
• Processes Phoned and/or faxed requests processed in a prompt and timely manner
• Stat requests and interdepartmental scheduling processed promptly;
• Contacts the facilities, physicians’ offices and/or insurance companies to resolve denials/appeals
• Schedules patient tests, and/or procedures in a prompt, courteous manner;
• Correctly utilizes the features of the Meditech system and accurately enters necessary information;
• Instructs patients and physician staff on authorization, test preparation and registration information;
• Establishes and maintains a working knowledge and vocabulary of procedures scheduled;
• Demonstrates the willingness and ability to process requests for diagnostic procedures and coordinates the Peer to Peer function as needs arise
• Checks patient orders for compliance with Medicare guidelines
• Processes physician’s orders in accordance with department standards
• Assists with orientation of new employees as needed and serves as a resource within the department;
• Displays confidence when processing difficult or interdepartmental requests;
• Recognized by customers as knowledgeable and helpful

Qualifications:

• 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 Speed 25 MBS Download and15MBS Upload
• Remote employees are required to live within 60 miles of an HCA hospital.

Parallon provides full-service revenue cycle management, or total patient account resolution, for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers and their communities.

HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

"There is so much good to do in the world and so many different ways to do it."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder

If you find this opportunity compelling, we encourage you to apply for our Precertification Representative opening. We promptly review all applications. Highly qualified candidates will be directly contacted by a member of our team. We are interviewing - apply today!

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.