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Responsible for collecting and entering complete and accurate demographic and insurance information prior to the patient’s arrival. Verifying that the pre-certification requirements of the insurance companies have been met. Verifying the benefits coverage and quantifying the patient liability portion. Contacting the patient the day before arrival to remind them of the appointment, set the expectation for payment, and answer any questions the patient may have.
FLSA: Non-exempt
EEO: □ 01 Officials and Managers □ 02 Professionals □ 03 Technicians □ 04 Sales Workers X 05 Administrative Support Workers □ 06 Craft Workers □ 07 Operatives □ 08 Laborers and Helpers □ 09 Service Workers
QualificationsMinimum EducationX High school diploma or equivalent X Required
Required SkillsRequires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action.
Certifications:X HFMA’s Certified Patient Account Representative (CPAR) designation- preferred
Minimum Work ExperienceMinimum one (1) year in customer service focused environment.
Computer, data entry experience.
Familiar with Third Party Payers Utilization Management Requirements for Outpatient Procedures.
Must possess an understanding of Medical Terminology and diagnostic procedures.
Previous scheduling or medical diagnostic department experience
Other
$52k-75k (estimate)
04/21/2023
06/15/2024
The following is the career advancement route for Pre-Certification Specialist positions, which can be used as a reference in future career path planning. As a Pre-Certification Specialist, it can be promoted into senior positions as a Member Certification Manager that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Pre-Certification Specialist. You can explore the career advancement for a Pre-Certification Specialist below and select your interested title to get hiring information.