Pre-Cert Specialist

Job Description

Job Description

Job Title: Precertification Specialist 
Location: Sandy Springs, in-office, full time 
Pay: $25/hr
Job type: Contract to hire 

Responsibilities: Handling pre-authorizations for oncology procedures. 

Prestige Staffing is hiring for a Pre-Certification Specialist for a well known healthcare system located in Sandy Springs, GA. This position is contract to hire and is looking to interview as soon as possible!

Hours : Mon-Fri, 7-3:30 during training, 7-8:30 start time with flexibility

Location : Sandy Springs, GA 

JOB DESCRIPTION:

• Initiates verification of eligibility and of plan benefits
• Notifies and authorizes all outpatient accounts
• Follows developed policies and procedures to obtain insurance benefits.
• Contacts third party payers for insurance benefits to verify eligibility
• Initiates pre-authorization for out-patient services.
• Identifies correct insurance plan, financial class, and coordination of benefits.
• Enters authorization documentation into appropriate systems.
• Responsible for obtaining clinical authorization by communicating patient and clinical information, medical necessity, and level of care to payers to secure account for reimbursement.

MINIMUM QUALIFICATIONS:

• High school diploma or equivalent
• Knowledge of drug HCPCS and diagnosis codes
• Ability to review physician notes in medical records
• Knowledge of Government, Managed care, and Commercial insurance payers requirements to obtain authorization for treatment.
• Typing skills and good communication skills
• Must pas criminal background and drug test (including THC)

#ZR-rep
#LI-Onsite
#LI-CH1