Verification & Precertification Specialist

Job Description

Job Description

Join Our Talent Pipeline—Where People Make the Difference!

Ellis & Badenhausen Orthopaedics, PSC is building a pipeline of qualified candidates for potential future opportunities as a Verification & Precertification Specialist. While there is not an immediate opening, we welcome applications from individuals who may be interested in joining our team as future staffing needs arise.

At Ellis & Badenhausen Orthopaedics, we believe our success is driven by the right people—individuals with the right aptitude, a positive attitude, and an entrepreneurial spirit. We are committed to providing the Louisville and southern indiana community with the highest level of orthopaedic care. By maintaining a skilled, experienced team and staying at the forefront of medical technology and research, we ensure that patient care remains our primary focus.

About the Role

As a Verification & Precertification Specialist, you would play a critical role in supporting the financial integrity of patient accounts and maximizing reimbursement. This position communicates with patients and responsible parties regarding financial obligations and insurance-related matters, helping create a smooth and efficient experience as patients prepare for clinic visits or surgical procedures.

If you are passionate about making a difference in patients’ lives and thrive in a collaborative, fast-paced environment, we would love to learn more about you and consider you for future opportunities

Key Responsibilities :

Insurance Authorization & Verification :

• Contact insurance companies for pre-certification requirements.
• Initiate authorization requests and submit medical records such as chart notes, imaging reports, and op notes.
• Confirm patient eligibility and benefits via websites and phone.
• Code surgical procedures accurately for insurance processing.

Communication with Patients :

• Provide surgical cost estimates to patients and explain insurance benefits.
• Offer patient collection advice based on coverage and procedure details.
• Update patient information in the system, including insurance details and demographics.

Documentation & Record Keeping :

• Scan and upload pertinent medical records to patient charts.
• Maintain detailed notes on insurance verification and pre-certification statuses.
• Ensure timely documentation of insurance and patient communications.

Problem Identification & Resolution :

• Identify insurance-related issues that could delay surgery and communicate with relevant staff.
• Report and escalate compliance or regulatory issues to the Office Manager.

Customer Service & Compliance :

• Provide high-level customer service to patients, insurance companies, and internal teams.
• Ensure adherence to HIPAA and OSHA regulations.
• Stay informed on relevant laws and industry policies to maintain compliance.

Collaboration & Efficiency :

• Collaborate with coworkers, physicians, and external partners to enhance workflow.
• Constantly seek improvements in efficiency and risk reduction.

Analytical & Decision-Making Skills :

• Review and interpret data for accuracy and compliance.
• Make informed decisions based on available information and regulatory requirements.

We are an equal opportunity employer

Ellis & Badenhausen Orthopaedics, PSC is an equal opportunity employer. All qualified applicants will receive consideration without regard to race, creed, gender, marital status, sexual orientation, color, religion, national origin, age, disability, veteran status, or any other status protected under local, state, or federal laws. Applicants must be eligible to work in the USA.