Job Details

Assures payment from outpatients' third party insurer by meeting all precertification requirements and by verification of patients' insurance coverage. Establishes controls so that patients understand and receive accurate information on their patient liability. Recruiter: Brittany Smithson || ...@covhlth.com Responsibilities Precertifies outpatient services in compliance with regulatory/insurance requirements. Verifies with insurance company the nature and extent of patients' insurance coverage. Follows-up on all claim denials for outpatient services. Determines the cause of denial, aggressively challenges wrongful denials and works with appropriate parties on resolutions. Assists off-site providers with procedural issues related to proper pre-certification and insurance verification requirements. Provides training to these locations as regulations/insurance requirement change and as employee turnover occurs. Participates with clinical, financial and utilization review departments to...Outpatient, Certification, Coordinator, Patient, Patient Services, Insurance, Healthcare