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Pre-Certification Specialist

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Job Description - Pre-Certification Specialist

Description

RESPONSIBILITIES INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING:

  • Verifies insurance coverage to ascertain deductible and coinsurance amounts, obtaining precertification/authorization.
  • Notifies patients of expected financial responsibility that will be due at the time of service.
  • Schedules pre-authorized services and follow-up office visits as needed.
  • Provides explicit instructions to patients regarding time of arrival, place of service, and documentation necessary for office visits.
  • Enters benefits and precertification/authorization into EMR system (Referral Management).
  • Coordinates with referring physician offices when necessary to pre-authorize services.
  • Coordinates with AOA business office to evaluate and resolve reimbursement issues.
  • Maintains work area in a neat and orderly manner at all times.
  • Attends scheduled staff meetings.
  • Availability to work in the office setting Monday-Friday.
  • Additional responsibilities as assigned by Director of CBO.


Requirements

 EDUCATIONAL REQUIREMENTS:

  • High School Diploma/GED or equivalent experience.

QUALIFICATIONS AND EXPERIENCE

  • Computer literate, with keyboard skills-working knowledge of practice management software.
  • One or more years’ experience in insurance verification / precertification in a medical office or hospital setting preferred.
  • Knowledge of medical terminology.
  • One year or more of work experience in various areas of medical insurance preferred.
  • Knowledge of CPT and ICD-9 coding.
  • Pleasant speaking voice and demeanor.
  • Neat, professional appearance.
  • Ability to perform in a highly stressful situation.
  • Ability to multitask.
  • Ability to focus and maintain direction in the tasks at hand under pressure.
  • Ability to establish effective working relationships with patients, physicians, insurance representatives and other medical support staff.
  • Background in medical terminology and orthopedics preferred.
  • Ability to analyze various medical situations for scheduling purposes
Original job Pre-Certification Specialist posted on GrabJobs ©. To flag any issues with this job please use the Report Job button on GrabJobs.
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