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Pre-Authorization Coordinator

Job Summary

Minimum of five years of relevant experience in a health care facility. Recommended areas of experience include but are not be limited to: provision of direct care in a medical office setting, chiropractic, urgent care, occupational healthcare, medical surgical or inpatient setting; record reviewer/case manager in the health insurance industry; clinical research; or case management.

Full Time

Demonstrates Competency in the Following Areas

Assisting in the establishment/implementation of goals, objectives, policies, procedures and systems for the department
Obtains, reviews and submits all medical documentation required for pre-authorization requests
Develop and handle all inbound peer to peer calls from peer reviewer physicians and nurse case managers for pre-authorization referrals
Facilitate resolution based on denial outcomes of the pre-authorization request
Measure and evaluate production for departments and staff
Maintains effective communication with staff
Run daily tasks and department referral logs monthly
Provide feed back to physicians regarding changes related to surgical authorizations and ODG guidelines
Run daily tasks as indicated and when requested by Director of the department

Regulatory Requirements

• Bachelor's Degree; prefer Doctorate Degree in Chiropractic

 

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Why Crescent regional Hospital?

At Crescent Regional Hospital, our goal is, and always has been, to cultivate a community of doctors, nurses, and administrators to breathe new life into a previously dying hospital as to provide a continuum of care for the communities of Lancaster, DeSoto, and all surrounding areas.  Unwavering in our vision and determined to not just be a choice in healthcare, but the choice in healthcare we need to hire the best from the community as to give the best care for the community.

Being of relative size to the communities we serve, both in staff and structure, allows us the ability to collaborate with and learn from one another as a means to provide treatment which is extensive, thorough, and specific to each patient. And because our internal culture is one of recognizing individual strengths and accomplishments, everyone gets their deserved moment to shine. As members of the Crescent Regional Family, we build one another up because we understand when we strive, our patients and community thrive which perpetuates us all into excellence.

 

We thank you for your interest in seeking employment with Crescent Regional Hospital and look forward to working with you when you become part of the Crescent Regional Family!