• Request and obtain prescriptions and authorizations from medical offices and insurance companies • Follow up with providers and payers to ensure timely receipt of required documentation • Resolve questions related to Certificates of Medical Necessity (CMN) and participating provider requirements • Re-verify patient eligibility for ongoing services • Maintain accurate, compliant documentation in accordance with HIPAA and regulatory standards • Communicate with patients, provider offices, and internal teams to resolve access-related issues

• Reviewing daily inpatient and observation admission reports to identify accounts requiring payer notification. • Submitting “Notification of Admission” requests to commercial, Medicare Advantage, Medicaid Managed Care, and other third-party payers in accordance with payer, regulatory, contractual, and client-specific requirements. • Verifying coverage, eligibility, and account information prior to submission to support clean, accurate notifications. • Documenting confirmation numbers, reference numbers, payer responses, and related communications in designated client and Guidehouse systems. • Monitoring pending notifications, follow up on outstanding requests, and resolve issues within required timelines. • Escalating accounts at risk for missed notification deadlines, authorization-related denials, or reimbursement impact. • Collaborating with Utilization Review, Case Management, and other operational teams to obtain supporting clinical or account information as needed. • Maintaining current working knowledge of payer-specific notification requirements, client workflows, and standard operating procedures. • Identifying trends contributing to notification delays, defects, or denials and communicate improvement opportunities to leadership. • Supporting quality assurance reviews, reporting activities, training reinforcement, and continuous performance improvement initiatives. • Meeting or exceeding productivity, quality, timeliness, and service level expectations established by Guidehouse and client organizations.

• Perform insurance verification and authorization functions that support Patient Access Services • Ensure compliance with department standards and billing requirements • Complete authorization initiation requests with payers for all service lines • Validate existing authorizations requested by providers • Provides necessary information regarding authorization numbers and patient demographic information to appropriate staff • Responds to "provider orders" for tests and procedures • Obtains authorizations for visits required by various payers

• Gathers information from patient and enters into appropriate database. • Seeks appropriate resources to resolve issues about the type, date or location of prescribed procedures. • Schedules patient procedures in a manner that most efficiently utilizes the patient's time and clinical resources. • Coordinates and communicates schedules. • Assists with coordination of activities related to insurance pre-certification/authorization. • Provides counseling to patient, participant or their representative regarding pre-service requirements and instructions. • Performs clerical and reception duties associated with patient registration. • Performs other duties as assigned.