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Pre-Authorization Rep

Mountain Management Services Chattanooga, Tennessee
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The posted compensation range of $15.00 - $20.33 /hour is a reasonable estimate that extends from the lowest to the highest pay CommonSpirit in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. CommonSpirit may ultimately pay more or less than the posted range as permitted by law.

Requisition ID 2024-383840 Employment Type Full Time Department Insurance Services Hours/Pay Period 80 Shift Day Weekly Schedule M-F Remote No Category Accounting and Finance
Overview

Mountain Management Services 

CHI Memorial Medical Group (Mountain Management Services), now part of CommonSpirit Health formed between Catholic Health Initiatives (CHI) and Dignity Health, is a Management Service Organization (MSO) that provides comprehensive office management services for all Memorial Health Partners and many physicians in private practice. We are proud to be a part of the regional referral center of choice providing health care throughout Southeast Tennessee and North Georgia.

We care about our employees’ well-being and offer benefits that complement work/life balance.

We offer the following benefits to support you and your family:

Free Membership to our Care@Work program supporting any child care, pet care, or adult dependent needs

Employee Assistance Program (EAP) for you and your family

Health/Dental/Vision Insurance

Flexible spending accounts

Voluntary Protection: Group Accident, Critical Illness, and Identity Theft 

Adoption Assistance

Paid Time Off (PTO) 

Tuition Assistance for career growth and development

Matching Retirement Programs

Wellness Program

If you are passionate about the patient experience and ready to join our nationally recognized hospital, connect with us today!


Responsibilities

This position is responsible for identifying and verifying the eligibility/benefits information for the patient’s visit. 

  • Enters insurance data into the computer and keeps patient accounts updated.
  • Enter and maintain insurance companies data
  • Obtains necessary referral numbers for HMO and PPO plans.
  • Process benefit correspondence
  • Coordinates record requirements with office managers as dictated by 3rd party payers
  • Initiate pre-cert for patients when required, obtaining precertification reference number, and utilization review company contact person and telephone number
  • Maintains patient and associate privacy and confidentiality.
  • Performs other duties as assigned.
  • Performs collection functions and financial assistance for payment methods
  • Collect point of service payments or link to financial assistance programs
  • Counsels patients regarding their third-party coverage, financial responsibility, and billing procedures
  • Must be capable of articulating information in a courteous, clear and informative manner to patients, guarantors, family members, clinical staff, other hospital personnel, vendors, physicians, and their office staff

Qualifications

Required Education: 

  • High school education or GED

Preferred Experience: 

  • Six months to one year insurance or related work experience preferred
  • Six months to one year experience in a medical office preferred
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Equal Opportunity

CommonSpirit Health™ is an Equal Opportunity/Affirmative Action employer committed to a diverse and inclusive workforce. All qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, marital status, parental status, ancestry, veteran status, genetic information, or any other characteristic protected by law. For more information about your EEO rights as an applicant, please click here.

CommonSpirit Health™ will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c). External hires must pass a post-offer, pre-employment background check/drug screen. Qualified applicants with an arrest and/or conviction will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, ban the box laws, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances. If you need a reasonable accommodation for any part of the employment process, please contact us by telephone at (415) 438-5575 and let us know the nature of your request. We will only respond to messages left that involve a request for a reasonable accommodation in the application process. We will accommodate the needs of any qualified candidate who requests a reasonable accommodation under the Americans with Disabilities Act (ADA). CommonSpirit Health™ participates in E-Verify.