Medical Office PreCertification Specialist

Medical Office PreCertification Specialist Location: Hainesport North American Medical Associates (NAMA) is a fast‑growing multi‑specialty medical practice dedicated to diagnosing, managing, and treating chronic pain and neurological disorders. We strive to improve patients' quality of life through integrated care. Job Summary: The Precertification Specialist is responsible for obtaining prior authorizations for all procedural orders by successfully completing the authorization process with all payers. Key Responsibilities: Review chart documentation to ensure patients meet medical policy guidelines. Prioritize incoming authorization requests according to urgency. Obtain authorizations via payer website or phone and follow up regularly on pending cases. Maintain individual payer files including up‑to‑date requirements needed to successfully obtain authorizations. Initiate appeals for denied authorizations. Respond to clinic questions regarding payer medical policy guidelines. Confirm accuracy of CPT and ICD‑10 diagnosis in the procedure order. Contact patients to discuss authorization status. Other duties as assigned. Knowledge, Skills and Abilities: Knowledge of procedure authorization and its impact on the practice’s revenue cycle. Understanding of payer medical policy guidelines; ability to apply them to manage authorization effectively. Basic understanding of musculoskeletal anatomy. Proficient use of CPT and ICD‑10 codes. Excellent computer skills (Excel, Word, internet). Detail oriented with above‑average organizational skills. Ability to plan and prioritize to meet deadlines. Excellent customer‑service skills; communicated clearly and effectively. Ability to multitask and remain focused while managing a high‑volume, time‑sensitive workload. Minimum Education / Certifications: 2 years of medical prior‑authorization experience preferred. 2 years of experience in a medical‑related field required. Minimum Work Experience: 5+ years of experience working in a call center or other customer‑service‑related position. Highly proficient in Microsoft Office and working with Electronic Medical Records. Ability to communicate issues to all levels of management. Compensation & Benefits: Hourly rate: $18 and up depending on experience. Benefits: Medical, Dental, Vision, Prescription, PTO, 401k and other miscellaneous benefits. We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status, or any other characteristic protected by law. #J-18808-Ljbffr North-American-Medical-Associates