Precertification Representative

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).

Do you have the career opportunities as a Precertification Representative you want with your current employer? We have an exciting opportunity for you to join Parallon which is part of the nation's leading provider of healthcare services, Parallon/HCA Healthcare.

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.

Benefits

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

• Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services

• Wellbeing support, including free counseling and referral services

• Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence

• Savings and retirement resources , including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling

• Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing

• Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts

Learn more about Employee Benefits (https://careers.hcahealthcare.com/pages/employee-benefits-and-rewards)

Note: Eligibility for benefits may vary by location.

Parallon (https://parallon.com/) 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.

"Bricks and mortar do not make a hospital. People do."- Dr. Thomas Frist, Sr.

HCA Healthcare Co-Founder

If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our Precertification Representative opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. Unlock the possibilities and 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.