University of Virginia Health System
POSITION SUMMARY: Obtains pre-certification for all inpatient admission and pre-authorization for all outpatient diagnostic tests and performs an administrative support function. This job requires the application and interpretation of policies and procedures and the use of independent judgment in a medical setting. The purpose is to achieve the goals and to meet the denial rates set by Patient Access the Medical Center and HSF to ensure minimum loss of revenue and maximum payment for services. The ability to maintain a working knowledge of carrier contracts/changes and departmental policies and procedures is required.
Analyzes information required to complete pre-certifications and/or authorizations with insurance carriers service area contacts and workmans compensation carriers.
Demonstrates skill in the proficient use of PC and UVA software systems to ensure that all pre-certification/pre-authorization information is entered into required computer systems in an accurate and timely manner.
Demonstrates the skills of effective communication decision-making and organization to ensure efficient job performance and job success.
Demonstrates ability to adhere to policies and procedures.
In addition to the above job responsibilities, other duties may be assigned.
Position Compensation Range: $17.31 - $26.83 Hourly
Education: High School Diploma or equivalent required. Associates Degree or Graduated from an accredited Licensed Practical Nurse Program preferred
Experience: 2 years relevant experience
License/Certification: Licensed to practice as a Practical Nurse in the Commonwealth of Virginia preferred
Job requires sitting for prolonged periods, attention to detail, must be able to hear, speak, read and write legibly.
The University of Virginia, including the UVA Health System and the University Physicians Group are fundamentally committed to the diversity of our faculty and staff. We believe diversity is excellence expressing itself through every person's perspectives and lived experiences. We are equal opportunity and affirmative action employers. All qualified applicants will receive consideration for employment without regard to age, color, disability, gender identity, marital status, national or ethnic origin, political affiliation, race, religion, sex (including pregnancy), sexual orientation, veteran status, and family medical or genetic information.