Precertification Coordinator

Description Accurately complete all fields in the patient demographic and insurance screens within the computer system. Call the patient’s insurance company to verify eligibility and obtain benefit coverage for office visits, outpatient tests, surgery, and inpatient admissions. Attempt to obtain and document in the computer system referral details and referral modifications for specialty care and testing for patients with insurance plans requiring formal referral documentation. Obtain and document in the computer system the precertification/preauthorization number from insurance companies prior to each surgical procedure and diagnostic test. Assist patients with scheduling new patient office visits with CVCP provider offices. Create and distribute the CVCP Inpatient and Outpatient Service Lists and manifests to CVCP surgeons and consultants. Complete all fields within the computer system necessary to process claims and re-route claims to the billing department per assigned deadline. Distribute The Admit List daily by 1 p.m., identify possible CVCP patients, and distribute the list to precertification staff for processing. Correct any account in which errors have occurred per the assigned deadline. Maintain constant communication among the physician, insurance company, and CVCP regarding authorization and the CVCP authorization status on patients. Maintain a minimum average of 30 CVCP authorizations per day with proven accuracy after 3 months. Required Experience / Qualifications Minimum 2 years of experience in working in precertification Working knowledge of managed care in all areas, most notably: referrals, insurance verification, and precertification. Knowledge of medical terminology Familiarity with ICD-9 and ICD-10 Strong analytical skills with the ability to assess and analyze trends to determine the most effective approach to bill Detail-oriented and strong critical thinking skills for solving problems on your own Ability to perform multiple tasks simultaneously and problem solve efficientlyExcellent organizational and interpersonal skills Strong desire to learn and utilize technology effectively Some experience with Microsoft Office including Teams Quickly able to enter data accurately and understand the information entered Flexibility to work overtime occasionally, typically when onboarding new clients Pay Rate: $24/hr #J-18808-Ljbffr Planet Pharma Group