Job Description
Essential Job Responsibilities: Obtains pre-authorizations/pre-certification per payer requirements for services and ensures authorization information is documented appropriately. Verifies physician orders are complete, determines CPT, HCPCS and ICD-10 codes for proper authorization. Ability to understand and communicate insurance co-pays, deductibles, co-insurances, and out-of-pocket expenses for
7:00 AM
Review the surgical and procedure schedule for the next 48–72 hours. Every case that requires authorization needs to be cleared be…
7:30 AM
Pull the PA worklist. Filter by date of service — cases with the earliest service dates get worked first. High-cost procedures (su…
8:30 AM
Submit PA requests to payers. Each payer has its own portal, its own forms, its own documentation requirements. You know them all…
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