3 Pre-Certification and Scheduling Specialist Jobs in Chesterton, IN
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Lakeshore Bone & Joint Institute Career Center
Chesterton, IN | Full Time
$43k-53k (estimate)
8 Months Ago
Pre-Certification and Scheduling Specialist
$42k-52k (estimate)
Full Time
1 Week Ago
Lakeshore Bone & Joint Institute is Hiring a Pre-Certification and Scheduling Specialist Near Chesterton, IN
Job DescriptionAs the region's dedicated experts in exceptional musculoskeletal care, our doctors and staff at Lakeshore Bone & Joint Institute have served the orthopedic needs of Northwest Indiana since 1968. With state-of-the-art facilities, we are dedicated to delivering the exceptional, compassionate care that our patients need to keep moving and keep enjoying their life.
The Pre-Certification and Scheduling Specialist is responsible for the following tasks:
Precertification/Prior Authorization & Scheduling
Essential Functions
Role Qualifications
Required Skills
ComplianceAll employees have a responsibility to comply with our organization’s policies and procedures, adhere to our Code of Conduct, complete required compliance training modules, and report any observations of non-compliance.
EEO StatementWe are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or Veteran status.
The Pre-Certification and Scheduling Specialist is responsible for the following tasks:
Precertification/Prior Authorization & Scheduling
- MRI
- PT/DME
- Surgery
- In Office Injections
Essential Functions
- Obtain authorization via payer website or by phone and follow up regularly on pending cases.
- Prioritize incoming authorization requests according to urgency.
- Maintain individual payer files to include up to date requirements needed to successfully obtain authorizations.
- Initiate appeals for denied authorizations.
- Schedule and coordinate patient surgeries and MRI’s.
- Communicate with surgical facilities and send all necessary surgical forms.
- Review surgery schedule with facilities the day before surgery; create and send email to physicians.
- Meet deadlines as determined by the date of procedure.
- Respond to clinic questions regarding payer medical policy guidelines.
- Confirm accuracy of CPT and ICD-10 diagnoses in the procedure order.
- Contact patients to discuss authorization status.
- Document all work in practice management system.
- Other duties as assigned.
- Strong attention to details.
- Time Management, prioritization, and sense of urgency.
- Basic understanding of insurance rules and regulations.
- CPT/ICD10 knowledge.
- Medical terminology.
- HIPAA compliance.
Role Qualifications
- Must be at least 18 years of age.
- Must have reliable transportation.
- Proficiency in Microsoft Word, Excel and Outlook preferred.
- Digital literacy.
- Work experience in a medical office setting preferred but will train the right candidate.
- Healthcare related background including surgical terminology preferred.
- Scheduling and pre-authorization experience preferred.
Required Skills
- Critical thinking and problem solving.
- Maintains composure and operates with emotional intelligence.
- Strong attention to detail.
- Receptive to and responsive to feedback.
- Excellent verbal and written communication skills.
- Time management, prioritization, and sense of urgency.
ComplianceAll employees have a responsibility to comply with our organization’s policies and procedures, adhere to our Code of Conduct, complete required compliance training modules, and report any observations of non-compliance.
EEO StatementWe are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or Veteran status.
Job Summary
JOB TYPE
Full Time
SALARY
$42k-52k (estimate)
POST DATE
05/19/2024
EXPIRATION DATE
06/11/2024
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