Lakeshore Talent

Lakeshore Talent is partnered with a leading Healthcare network in their search for Preauthorization Specialists for several contract roles of approximately 3 months with the possibility of extension and/or hire. Our client is seeking candidates with precertification / preauthorization experience and a passion for helping others! 

LOCATION: Warrenville, IL

HOURS: 8:30am-5pm Monday to Friday

RESPONSIBILITIES:

  • Responds to telephone inquiries and performs appropriate action(s)

  • Documents all actions taken in the appropriate software applications

  • Monitors admission / registration and scheduled surgeries flow of patient information through the revenue cycle

  • Serves as a resource to staff and patients for insurance related issues

  • Reviews patient electronic medical record for appropriate diagnosis and pre-treatment rendered

  • Consults with physicians and their assistants whenever questions arise to insure timely approvals

  • Follows through and makes corrections in demographics and insurances as they are discovered

  • Insures all admissions, scheduled surgeries, and certain outpatient procedures are financially cleared, to allow for maximum and timely reimbursement to the hospital

  • Interacts with various hospital departments and physicians offices to effectively schedule and direct patients through systems in a patient/customer friendly manner

  • Performs medical necessity checks as necessary for scheduled services, communicates options to patient if appointment fails

  • Informs patients of any issues with securing the financial account for their encounter and completes out-of-pocket estimations as requested by patients

 

REQUIREMENTS:

  • Post high school education preferably a degree in Accounting or Finance

  • Customer service experience preferably in a hospital setting

  • Familiarity with insurance plans, EPIC and Medicare and Medicaid

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