Retro Certification Specialist
, Missouri
December 17, 2017
Position Summary: Review medical records to extract the discharge planning information into a form to justify why a patient is in need of the duration at the hospital and for the care received. Document patient condition, medications, diet and procedures performed.

  1. Review each Medical record to understand the condition and treatments received.
  2. Extract necessary information to justify the necessity of stay for Insurance approval.
  3. Analyzing and reviewing medical records for sensitive information that may require special authorizations.
  4. Communicate directly with Insurance Agency to justify requests for authorization
  5. Complete necessary forms to submit to agency for approval.
  6. All other job duties as assigned by management

  • Qualifications:
  • Knowledge: Working knowledge of medical records processing. Relevant work experience and training including familiarity with Coding, CPT, Medical Terminology and Credentialing.
  • Experience: At least 5 years experience in hospital or physician billing including 2 years in a supervisory role and a working knowledge of medical terminology dealing with insurance related issues. Experience with standard office software products a must.
  • Skills/Aptitudes: Demonstrated analytical, communication and problem solving skills and the ability to act/decide accordingly. Ability to collect, create and research complex or diverse information. Exceptional customer service and the ability to plan organize and exercise sound judgment.
  • LVN at minimum is required

A little about us:
HCA is the nation’s leading private provider of healthcare services. Comprised of locally managed facilities which include 230,000 employees at over 160 hospitals, over 120 surgery centers and 100 urgent care facilities in 20 states and the United Kingdom

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