Precertification Specialist

Precertification Specialist

Job Category: Patient Services

Full-Time

On-site

Decatur, AL 35601, USA

Description

Responsibilities/Requirements:

• Pre-certify all patients for office visits, consultations, testing, and procedures as required by each patient's insurance company by monitoring patient schedules in the billing system for each department
• Follow insurance company pre-certification requirements for approval, such as calling, faxing, emailing, logging into their system online, etc.
• Assist accounts receivable, coding, registration, and insurance follow up staff on an as-needed basis
• Answer requests from various departments regarding pre-cert requirements for various insurance companies
• Reviews pre-cert requirements for insurance companies in a timely manner to maintain up-to-date knowledge of requirements
• Notifies appropriate staff on status of approval/denials.
• Forwards denials to manager and appropriate staff for further review and decision making
• Maintains strict confidentiality
• Performs related work as required

Must also possess:

• HS/GED required
• Ability to communicate effectively with patients, DOC physicians and staff
• Ability to work under pressure and deadlines
• Outstanding organizational, verbal and writing skills
• Independent, highly motivated
• Exhibit initiative and self-discipline
• Proven positive, "teamwork" attitude and work history
• Previous insurance precert experience preferred
• Previous surgery or procedure scheduling preferred

Physical Demands:

• Must be able to use arms, hands, and fingers skillfully
• Constant sitting for long periods of time
• Must be agile and able to work efficiently in space limited areas
• Consistently work at a productive pace

Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.