AR Precertification Specialist

Primary Responsibilities/Requirements:

• Pre-certify all patients for office visits, consults, testing, and procedures as required by each patient’s insurance company by monitoring patient schedules in the billing system for each department
• Follow insurance company pre-certification requirements for approval, such as calling, faxing, emailing, logging into their system online, etc.
• Assist accounts receivable, coding, registration, and insurance follow up staff on an as-needed basis
• Answer requests from various departments regarding pre-cert requirements for various insurance companies
• Reviews pre-cert requirements for insurance companies in timely manner to maintain up-to-date knowledge of requirements
• Notifies appropriate staff on status of approval/denials.
• Forwards denials to manager and appropriate staff for further review and decision making
• Maintains strict confidentiality
• Performs related work as required

Must also possess: 

• HS Diploma/GED required
• Three years insurance and/or billing experience preferred
• One year of healthcare experience preferred
• Coding, AR, Insurance reimbursement knowledge required.

• Ability to work under pressure and meet deadlines
• Outstanding organizational, verbal and writing skills
• Independent and highly motivated
• Initiative and self-discipline
• Proven positive, "teamwork" attitude in work history

Physical Demands:

• Must be able to use arms, hands, and fingers skillfully
• Constant sitting for long periods of time
• Must be agile and able to work efficiently in space limited areas
• Consistently work at a productive pace
• Must readily adapt to frequent treatment schedule changes