Pre-Certification Specialist
CharterCARE Health of Rhode Island, Inc
About this position Pre-Certification Specialist Summary : Responsible to obtain all required authorizations prior to treatments being performed in the Cancer Center/Infusion Suites, including verification of patient insurance coverage, benefit levels and out of pocket responsibilities. Responsible to obtain, entry, and track all authorizations and pre-certs as required by the individual insurance company. The specialist will be familiar with and understand Medicare, Medicaid, other government payers, Commercial and HMO/PPO Payers guidelines and principals. Education : High School Graduate or GED required. Associate’s level degree preferred. Knowledge of CPT, ICD 10 coding and J Codes. Knowledge of insurance coverages and reimbursement practices. Experience : Prior experience working in a related role in a medical office or other health care related organization. 2-3 years of prior insurance verification and preauthorization work or related experience in a health care environment. Skills and Abilities Strong verbal and written communication skills Strong computer skills Ability to work both independently and as a member of a team Ability to remain organized and detail oriented while working at a fast pace Ability to work independently as well as to function effectively and collaboratively in a team environment Advanced organization skills and ability to handle multiple tasks Proficient with computer applications, a thorough understanding of the Microsoft Office suite, internet usage and the ability to learn and master other computer technology / software programs as needed Excellent follow-through and persistence when communicating with patients and members of our community participating in our programs #J-18808-Ljbffr
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