Carle Health
10,000+ employees
Founded 1946
⚕️ Healthcare Insurance
📚 Education
Healthcare Insurance • Healthcare • Education
Carle Health is a comprehensive healthcare provider dedicated to managing the health needs of its community. Offering a wide range of services, from general medical care to specialized treatments in oncology, cardiovascular, pediatrics, and women's health, Carle Health emphasizes quality patient care and community health initiatives. Additionally, it supports education and research through the Carle Illinois College of Medicine and engages in community health programs that aim to improve overall well-being.
Pre-Authorization Specialist
🔥 0 minutes ago
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Carle Health
10,000+ employees
Founded 1946
⚕️ Healthcare Insurance
📚 Education
Healthcare Insurance • Healthcare • Education
Carle Health is a comprehensive healthcare provider dedicated to managing the health needs of its community. Offering a wide range of services, from general medical care to specialized treatments in oncology, cardiovascular, pediatrics, and women's health, Carle Health emphasizes quality patient care and community health initiatives. Additionally, it supports education and research through the Carle Illinois College of Medicine and engages in community health programs that aim to improve overall well-being.
📋 Description
• Responsible for identifying prior auth requirements by insurance/payer • Processes and completes prior authorizations • Determines if services are a covered benefit • Communicates with the ordering Provider's office • Advocates for patients/providers by processing pre-auths in a time sensitive manner • Identifies challenges, trends and patterns
🎯 Requirements
• Must have direct portal experience • Proficiently utilizes third party payer/insurance portals • Detailed knowledge of insurance providers • Must document pre-authorization results completely • Collaborate with physicians and nurses to secure clinical information needed for submissions.
🏖️ Benefits
• comprehensive benefits package
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