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Authorization/Surgical Scheduling Representative Days FT
Under general supervision is responsible for contacting third party payers and obtaining authorizations/referrals for specialty physicians for all diagnostic testing and in-patient/out-patient surgical procedures. Interprets Managed Care contracts and other third party payer contacts in order to secure correct authorization and/or referral. Assures authorizations/referrals and re-authorizations are obtained and secured for patients. Obtains appropriate clinical data for admission and out-patient surgery. Verifies eligibility and benefits of patient plans to assure proper processing of referrals. Informs patients of delays due to eligibility or benefit issue within forty-eight hours. Educates patients, staff and physicians on latest insurance requirements with
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