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Sr. Precertification Rep at Temple Health System

Philadelphia, Pennsylvania, United States -

Full Time

Start Date

Immediate

Expiry Date

07 Feb, 26

Salary

0.0

Posted On

09 Nov, 25

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Precertification, Authorization, Oncology, Peer To Peer Review, Appeals, Financial Information, Insurance Verification, Billing Requirements, Reimbursement, Chemotherapy, Radiation Oncology, Rehabilitation, Dialysis, Organ Transplant, Utilization Review, LPN

Industry

Hospitals and Health Care

Description

This position is responsible for obtaining and managing ongoing precertification/authorization for complex oncological hospital services. Responsible to coordinate peer to peer review and appeals of denials due to no authorization. Responsible to confirm the financial/insurance information obtained during the registration process to determine that State, Federal and Third Party precertification/billing requirements are met to ensure optimal reimbursement for services to be rendered. Education Associate's Degree in related field Required Non Degree Program Graduate of an accredited LPN program Preferred or Combination of relevant education and experience may be considered in lieu of degree Required Experience 3 years experience in a pre-certification/utilization role Required 3 years experience in precertification processes for oncological or other specialized medical services such as chemotherapy, radiation oncology, rehabilitation, dialysis, or organ transplant Required Licenses PA Practical Nurse License Preferred Cert Prof Utilization Review Preferred

Responsibilities

This position is responsible for obtaining and managing ongoing precertification/authorization for complex oncological hospital services. It also involves coordinating peer to peer review and appeals of denials due to no authorization.