Senior Patient Access Intake Spec-Rehab

Southcoast Health System -  - Responsibilities:
Determine patient liability prior to service by creating an estimate based on individual payer;
Initiate contact with patients, clinicians, and third party payers to obtain pre-certification and authorization for evaluations and diagnostic tests;
Use critical thinking to ensure CPT codes are documented and authorized for the appropriate service;
Navigate multiple payer portals to determine requirements for authorization and submit electronic requests;
Follow up with payer denials by researching clinical data to support an appeal