Coordinator, Precertification - Administration - Full Time
Guthrie
Summary: Under general supervision, to perform a variety of routine to moderately difficult office support activities, which may include recordkeeping, working in online portals, processing forms, report preparation, typing, and filing; and functioning as a positive and cooperative team member
Experience: 1 year of applicable cumulative job specific experience required. *Note: Required professional licensure/certification can be used in lieu of education or experience, if applicable.
Education, License & Cert: High School Diploma or GED Required
Essential Functions: Coordinates with Home care, clinical staff and insurance companies in obtaining authorization for all home health and hospice admissions.
Responsibilities:
Obtains authorization on for admissions as required by health plans.
Enter patient insurance authorizations and any pertinent information from insurance company into the patient account history.
Documents insurance coverage of services to be provided.
Notifies case management about interactions with insurance companies regarding services.
Communicate with clinical staff to coordinate appropriate staff visits
Communicates any changes in insurance coverage with office and clinical staff
Manage denials or potential denials as described by the insurer.
Monitors and reviews the applicable schedule to ensure that authorization and initial length of stay is obtained and on file.
Proficiency in online portals, and good computer skills.
Must have excellent communication skills.
Other duties as assigned
Joining the Guthrie team allows you to become a part of a tradition of excellence in health care. In all areas and at all levels of Guthrie, you’ll find staff members who have committed themselves to serving the community.
The Guthrie Clinic is an Equal Opportunity Employer that welcomes and encourages diversity in the workplace.
The Guthrie Clinic is a non-profit, integrated, practicing physician-led organization in the Twin Tiers of New York and Pennsylvania. Our multi-specialty group practice of more than 500 physicians and 302 advanced practice providers offers 47 specialties through a regional office network providing primary and specialty care in 22 communities. Guthrie Medical Education Programs include General Surgery, Internal Medicine, Emergency Medicine, Family Medicine, Anesthesiology and Orthopedic Surgery Residency, as well as Cardiovascular, Gastroenterology and Pulmonary Critical Care Fellowship programs. Guthrie is also a clinical campus for the Geisinger Commonwealth School of Medicine.
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