Brianne Jines

Obtain inpatient and outpatient insurance authorizations for surgery

Input authorization information into epic

Coordinate with surgery scheduling for urgent cases and add ons

Set up peer to peers with provider for denied cases

Maintain list of all surgeries authorized

• Complete authorizations and referrals for services
• Review patient's medical history and insurance coverage for approval
• Contact referring physicians for additional information as needed.

• Verify patients insurance, benefits, and eligibility
• Pre-cert for inpatient surgery, and outpatient procedures
• Understanding of payer medical policy guidelines
• Confirm accuracy of CPT and ICD 10 diagnoses
• Prioritize incoming authorizations, according to urgency
• Obtaining insurance authorizations from insurance company and documenting approval in EPIC
• Collect self-pay payments for surgery
• Distribute patient payments to prior balances on account.

• Pre- and post-op patient care, obtain vital signs, update medication lists
• Staple/suture removal, dressing/unna boot changes, autoclaving
• Registration, collect co-pays in prior balances, schedule appointments, and testing.