Prior authorization representative vs patient liaison

Differences between prior authorization representative and patient liaison duties and responsibilities

Prior authorization representative example responsibilities.

• Manage inbound/outbound calls for medical personnel and patients, along with computerize data entry to regulate proper distribution of prescription medication.
• Utilize knowledge of physician office policies, CPT and ICD-9 coding, procedures, and equipment.
• Provide compassion without judgment in regards to patient's finances.
• Determine if CPT and ICD-10 codes are correct and qualify for coverage.
• Review all daily EDI reports to make sure claims are being accept properly.
• Perform chart audits via EMR, prepare medical records for subpoenas, general requests.
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Patient liaison example responsibilities.

• Provide support for emergencies by managing inappropriate behaviors, aggressive patients, CPR and persons in crisis.
• Conduct all insurance verification and obtain authorization to treat sub-acute rehabilitation patients.
• Attend Michigan state eligibility hearings, when necessary to assist and gain Medicaid disability benefits for patients.
• Interview patients of hospital facility to obtain necessary documentation to secure Medicaid coverage as payment of inpatient hospital charges.
• Set up payment plan, verify personal information per HIPAA guidelines.
• Respect and maintain HIPPA and patient confidentiality and dignity of patients at all times.
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