Pre-Certification Specialist- Prov Laurel 5619 in Columbia, SC at Providence Health
Posted on: 3 Apr 2021
Columbia, SC
Job Description
Job Description
Providence Health
Founded as Providence Hospitals in 1938 by the Sisters of Charity of St. Augustine, Providence's two free standing full-service hospitals and numerous satellite practices maintain a true devotion to advanced clinical expertise and unmatched compassion. On February 2, 2016, Providence became part of the LifePoint Health network, and shortly thereafter, changed its name to Providence Health to better represent the full complement of its services. Driven by quality, compassion, and Christ, Providence treats the whole person- body, mind, and spirit.
Providence Heart Laurel Street are looking for a Pre Certification Specialist to join our team.
Providence Medical Group's team of cardiologists are known throughout the Midlands for providing top quality cardiac care, and not just by the patients and other physicians. Our cardiologists are recognized industry-wide for their success treatment of heart disease. In fact, Providence cardiologists are repeatedly selected by device developers to introduce cardiovascular products and procedures to the Midlands because of our strict commitment to quality and history of successful outcomes for the patient.
For more information about the services provided and Physicians at Providence Heart, click here.
Essential Functions
* Demonstrates a thorough working knowledge of pre-certification requirement and medical necessity criteria by ensuring patients have appropriate authorizations, pre-certification and referrals prior to admission or procedure
* Communicates with diverse patient groups in order to assess age specific data and provides that data to other care givers as needed.
* Verifies and enters benefits on insurance for all patient services. Obtains benefits a minimum of 24 hours after procedure for all urgent patients
* Reviews patient orders for accuracy and completeness, i.e., diagnosis for medical necessity, signatures, etc.
* Counsels patients appropriately in situations where insurance companies deny benefits by explaining waiver to patients and answering questions
* Interacts effectively with other physician offices
Job Requirements
Minimum Work Experience
Two years experience in medical billing
Minimum Education
High school diploma or equivalent
Location
2001 Laurel Street
Columbia, SC 29204
Hours
Monday through Friday: 8:00 AM to 5:00 PM
LifePoint Health is committed to providing Equal Employment Opportunities for all applicants and employees and complies with all applicable laws prohibiting discrimination against any employee or applicant for employment because of color, race, sex, age, religion, national origin, disability, genetic information, gender identity, sexual orientation, veterans status or any other basis protected by applicable federal, state or local law.
LifePoint Health, Inc.
Brentwood, TN
Across our network and at our Health Support Center, we are united by a shared mission and vision, core values and guiding principles that drive everything we do and inform our approach to patient care, quality and how we do busine. We know that to achieve our vision of creating places where people choose to come for healthcare, physicians want to practice and employees want to work, we must organize around the right strategies. At LifePoint, our strategies are simple and enduring.
Our Operating Groups
LifePoint's facilities and practices are divided into four operating divisions: Eastern, Central, Mountain and Western. Each of these divisions has a leadership team that mirrors a hospital's leadership team, including a president and dedicated physician and provider leadership resources.
Our Health Support Center
Our Health Support Center (HSC), in Brentwood, Tennessee, has subject matter expertise in every area of healthcare operations and provider services. The HSC is organized to bring resources to bear across the continuum of care, from before a patient accesses healthcare services to after they are sent home, while keeping quality and compliance at the center.
On a daily basis, our group leaders and subject matter experts are working with our local markets to help develop and implement the right strategies that ensure healthcare thrives in their communities.
Our Physicians
Physicians are a critical access point to care in our communities. We work to build and maintain collaborative relationships with both our employed physicians and a broad network of affiliated providers, and we provide a full spectrum of practice management and physician support to help secure the delivery of quality care today and for the future.
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IndustryHealthcare
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No. of Employees60,000+
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Website
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Jobs Posted13300
