PCC Authorization Associate I

Overview:
Contacts insurance companies and other third party payers to determine pre-certification, pre-authorization and/or medical necessity requirements for basic and moderately complex hospital outpatient visits. Obtains pre-certification or pre-authorization prior to the scheduled service being performed. Liaisons with physicians and physician office staff when needed to obtain additional demographic, insurance or clinical information. Notifies the payer of admission if required.

Responsibilities:
Contacts insurance companies and other third party payers to determine pre-certification, pre-authorization and/or medical necessity requirements for basic and moderately complex hospital outpatient visits. Obtains pre-certification or pre-authorization prior to the scheduled service being performed. Liaisons with physicians and physician office staff when needed to obtain additional demographic, insurance or clinical information. Notifies the payer of admission if required.

Qualifications:
EducationH.S. Diploma or General Education Degree (GED) Required
Bachelor’s Degree from a recognized college or university Preferred
Completion of medical coder training program Preferred Work Experience2 years in Healthcare Revenue Cycle or related healthcare experience Required
3 years related healthcare Revenue Cycle experience within precertification/authorization Preferred Licenses and Certifications None Required
Certification with Healthcare Financial Management Association Preferred
Certified Revenue Cycle Representative Preferred

Business Unit : Company Name:
Piedmont Healthcare Corporate