Job Description
Precertification Specialist Location Savannah, GA (Oakdale area) :
Obtains pre-certification, prior approval or pre-determination authorization for scheduled tests and surgical procedures by contacting patient's insurance company for eligibility, pre-existing, or exclusions.
Responsibilities:
- Determines if testing or procedure is covered by patient's policy and whether prior authorization or a letter of pre-determination is required.
- Contacts insurance companies to provide patient medical history, current diagnosis and planned testing or surgical treatment.
- Interacts with assigned patient care teams to secure any additional documentation needed to obtain prior authorization.
- Continues to follow up with insurance companies to confirm status of requess, documenting approvals and/or denials in AllScripts and Experior.
- Partners with surgeon and patient care team to facilitate a peer-to-peer review or appeal if this is considered in the patient's best interest.
- Notifies billing manager and administration if there are any patterns that may require a change in documentation, work flows, etc.
Requirements:
- A High School Diploma is required.
- A minimum of 2-3 years experience in medical background required; at least 1 year of experience in pre-certification or insurance verification is preferred
Job Type: Full-time
Pay: From $17.00 per hour
Expected hours: 40 per week
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Weekly day range:
- Monday to Friday
- No weekends
Experience:
- Surgical pre-certification: 2 years (Required)
Work Location: In person
Job Tags
Hourly pay, Full time, Flexible hours, Monday to Friday,