Arnot Health

Representative

• Work within a team to pre-authorize outpatient exams for various hospital services
• Report directly to the Pre-Authorization Supervisor
• Answer telephone calls professionally and courteously
• Use computer networks and telephone applications to obtain patient pre-authorizations
• Complete pre-authorizations promptly and accurately
• Check appointment schedules daily to confirm admissions and procedures are approved by insurance carriers
• Apply insurance knowledge, ICD-9/CPT/HCPCS coding, Medicare requirements, and medical terminology
• Pre-authorize and pre-certify patient exams across departments
• Sequence exams and prioritize work
• Communicate questions to appropriate departments and help resolve pre-authorization problems
• Cross-train for other departmental responsibilities as required
• Maintain computer security and participate in quality improvement monitoring and reporting
• Collaborate with physicians, physician offices, and other health team members
• Perform additional duties assigned by the supervisor or manager
• Follow risk management, safety, emergency-code, confidentiality, professionalism, and customer-service standards
• Attend staff meetings and mandatory annual educational programs

Preauthorization Representative