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Precertification Specialist - Atlanta, GA
$36k-45k (estimate)
Full Time | Ambulatory Healthcare Services 4 Months Ago
Save

Alliance Spine and Pain Centers is Hiring a Precertification Specialist - Atlanta, GA Near Atlanta, GA

Job Summary
Under general supervision verifies insurance, obtains referrals and pre-certs for surgeries and other procedures. Educates patients regarding the cost of treatment, insurance coverage and the patient’s responsibility for ensuring payment for all financial obligations to Alliance Spine & Pain Centers (ASPC).
Essential Duties and Responsibilities
  • Identifies and obtains a referral authorization when appropriate. Verifies appropriate network for claims processing. Verifies and updates insurance benefits and referral information for existing patients and ensures current pre-certifications are obtained for procedures. Obtains a new referral when necessary.
  • Updates patient accounts in practice management system.
  • Generate Letters of Medical Necessity as requested by Insurance Carriers.
  • Maintain an in depth awareness of billing policies and procedures.
  • Responds to staff or patient’s questions regarding insurance procedures and policies.
  • Serves as patient advocate during the cycle of the patient’s account as needed.
  • Notes information regarding patients’ benefits in the practice management system.
  • Attends insurance related meetings on and/or off-site.
  • Completes work within authorized time to assure compliance with departmental productivity.
  • Maintains clean and orderly workspace and organized files.
  • Clearly communicates thoughts verbally and in written form.
  • Maintains positive working relationship with patient concierges, Revenue Cycle managers and directors, and Regional Administrators.
  • Demonstrates knowledge of, and supports, ASPC/ IMS’ mission, vision, standards, policies and procedures, operating instructions, confidentiality standards, and the Code of Ethical Behavior.
  • Performs other assigned duties and special projects.
  • Ensures compliance with JCAHO.
  • Complies with all applicable HIPPA rules and regulations.
Education/Experience/Skills/Certifications
High School diploma or GED required. Three years’ insurance verification, medical billing and collections experience required. Knowledge and understanding of Medicare and Managed Care guidelines. Must be organized, detail oriented, accurate, and possess the ability to work independently. Strong oral and written communications skills. Experience with a computer based billing system (eClinical preferred) and Microsoft Office applications (Excel, Word and Outlook).
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel and talk or hear. The employee frequently is required to reach with hands and arms. The employee is occasionally required to stand and walk. The employee must occasionally lift and/or move up to 20 pounds. Specific vision abilities required by this job include close vision, color vision, peripheral vision, depth perception, and ability to adjust focus.
Work Environment
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The noise level in the work environment is usually moderate.
Possible exposure to infectious/contagious disease, hazardous chemicals and materials, needle sticks, blood and body fluids

Job Summary

JOB TYPE

Full Time

INDUSTRY

Ambulatory Healthcare Services

SALARY

$36k-45k (estimate)

POST DATE

12/03/2023

EXPIRATION DATE

05/09/2024

WEBSITE

spinepains.com

HEADQUARTERS

CARTERSVILLE, GA

SIZE

100 - 200

FOUNDED

2007

TYPE

Private

CEO

THOMAS E HURD

REVENUE

$5M - $10M

INDUSTRY

Ambulatory Healthcare Services

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About Alliance Spine and Pain Centers

Alliance Spine and Pain Management is a healthcare company that treats patients suffering from spinal cord ailments.

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