Medical Authorization Executive
Neuron LLC
Total years of experience :14 years, 3 Months
• Overall knowledge of authorization, benefits, and claims processing for insurance companies.
• Demonstrates the ability to make decisions assess and resolve problem effectively.
• Maintain patient confidentiality as defined by state and company regulations
• Answers calls from physician offices, hospitals, and patients using exemplary customer service skills.
• Accurately enters required information (clinical and non-clinical) into computer database.
• Reviews clinical data and matching it against specified medical terms and diagnoses (without the need of supervision) and follow established procedures for authorizing request or referring request for further review.
• Provides pre-authorization codes as needed and file completed pre-authorization requests as per established procedures.
• Print and send authorization letters from system as directed.
• Manage multiple tasks and demands while ensuring a high degree of accuracy and attention to detail.
• Assist members with questions and concerns regarding their account.
• Utilizing the nursing processes, assessment, planning, providing and evaluating nursing care based on evidence, professional practice and research.
• Provides goal-oriented patient care by utilizing established nursing processes and principles.
• Orienting the patient and relatives about hospital policies, facilities, and services
• Establish nursing diagnosis, plan of care, formulation of implemented treatment and evaluation of care.
• Initiate and maintain IV lines as ordered by the physician.
• Collaborates with other ER professionals to ensure effective patient care delivery to achieve the desired patient results.
• Acts as a team member/leader to perform ER tasks.
• Identify patients’ conditions to address nursing care.
• Auditing ER supplies and equipment.
Bachelor of Science in Nursing