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Company: Emerus Holdings Inc.
Location: Houston, TX
Career Level: Associate
Industries: Healthcare, Pharmaceutical, Biotech

Description

The purpose of this position is to obtain the necessary insurance authorizations for health services provided by the company.



Basic Qualifications

  • High School Diploma or GED required
  • Two years insurance verification and/or authorization experience required
  • Expert knowledge of various payers and payer insurance cards required
  • Knowledge of Microsoft Office Tools (Microsoft Word, Excel and Outlook), required
  • Position requires fluency in English; written and oral communication


Essential Job Functions

  • Complete daily authorization requirements from all hospitalizations
  • Reviews admissions for accuracy of insurance, coordination of benefits, and status
  • Obtains clinicals, diagnosis information and ICD10 codes as necessary for completing the insurance authorization process
  • Ensures insurance carrier documentation requirements are met and authorization documentation is scanned and documented in the patient's record.
  • Review and submit all follow-up requirements for further days certified.
  • Works closely with Patient Access and the Billing Department on account updates and authorization activity.
  • Works with Case Management on all denials and/or peer to peer reviews
  • Maintains a good working knowledge of authorization requirements for all payors and state/federal regulatory guidelines for coverage and authorization of services provided.
  • All of tasks as assigned.


 Apply on company website