Position : Precertification Specialist

Location : Flushing, NY

Duration : 2 Months

Shift :

9 : 00 am - 5 : 00 pm (includes a 60-minute break)

Department : OBGYN - 207245

OBGYN - 207245

Job Summary :

The Precertification Specialist is responsible for managing the precertification process for OB / GYN ultrasounds and related procedures.

This role ensures all necessary insurance pre-authorizations are obtained in a timely and efficient manner, contributing to smooth patient care and administrative operations at NYP Queens.

Essential Job Functions :

Precertification and Authorization :

• Obtain insurance precertification for OB / GYN ultrasounds and other related procedures.
• Utilize knowledge of CPT codes and medical terminology specific to OB / GYN services.

Insurance Verification :

• Verify patient insurance coverage and benefits.
• Communicate with insurance companies to confirm patient eligibility and coverage details.

Patient Coordination :

• Coordinate with patients to collect necessary information for insurance verification and precertification.
• Inform patients of their insurance status and any necessary steps they need to take.

Documentation and Record-Keeping :

• Accurately document all interactions and transactions related to precertification and insurance verification in the Electronic Health Record (EHR) system.
• Ensure compliance with all relevant regulations and policies.

Use of EHR Systems :

• Maintain up-to-date knowledge of EHR functionalities and updates.

Interdepartmental Coordination :

• Work closely with medical, administrative, and billing departments to ensure seamless patient care and service delivery.
• Communicate effectively with healthcare providers to resolve any issues related to precertification.

Human Relationship Skills :

• Demonstrate strong interpersonal skills in interactions with patients, families, insurance representatives, and healthcare team members.
• Address and resolve patient concerns related to insurance coverage and precertification.

Additional Duties :

Perform other duties and projects as assigned by the department supervisor.

Required Skills & Experience :

• Education :
• High School Diploma (Required).
• Experience :
• Minimum of 2 years of job-related experience, particularly in a healthcare setting.
• Experience with insurance verification and obtaining insurance precertification.
• Proficiency in using EPIC or similar Electronic Health Record systems (Required).
• Skills :
• Strong knowledge of OB / GYN ultrasound procedures and CPT codes.
• Excellent human relationship and communication skills.
• Ability to manage multiple tasks and prioritize effectively.

Last updated : 2024-05-20