Health Insurance and Authorization Representative IV

The individual in this position manages and provides financial account management for assigned caseload. Identifies and determines the accuracy and completeness of insurance and demographic information to ensure case is secure prior to discharge. Identifies problems that include but are not limited to pre-certifications, Utilization Management, Medicaid Pending, third party payer issues, and denials/appeal processes. Involves in-depth communication and follow-up with assigned area, Financial Assistance, Social Work, Utilization Management, Medicaid Enrollment & Outreach, patients, families, third-party payers, and governmental agencies.