Precertification Specialist

JOB DESCRIPTION

JOB TITLE: PRECERTIFICATION SPECIALIST

IMMEDIATE SUPERVISOR:  DIRECTOR OF OPERATIONS

MINIMUM QUALIFICATIONS:

• Cooperative work attitude toward co-employees, management, patients, visitors, and physicians
• Ability to make logical decisions and solve problems
• Knowledge of CPT and ICD-10 coding applications
• GI knowledge a plus!

REQUIREMENTS:

• High school diploma or GED certificate
• Good communication skills
• Good computer skills
• Strong ethical and moral character references
• Pass background, drug, security check

DUTIES AND RESPONSIBILITIES

1.    Communication

• Communicates effectively and professionally with patients,

      visitors, physicians, and co-workers

• Interacts with others in a positive, respectful, and considerate manner
• Conducts self as a positive role model and team member
• Respects patients’ rights to privacy, dignity and confidentiality

2.    Duties

• Works daily schedule to ensure all procedures and any scheduled tests are preauthorized with insurance company
• Documents all communication in computer
• Receive calls related to patient authorization or precertification from patients or insurance companies
• Work with area medical centers to ensure appropriate authorizations are done
• Forwards all complex problems or questions to business office team lead

3.  Job Quality Requirements

• • Accuracy
  • Attention to detail
  • Timeliness

• • Organization
  • Little supervision needed to accomplish task

4.   Dependability

• • Attendance
  • Punctuality
  • Ability to follow instructions

• • Ability to meet deadlines

5.         Physical / mental Requirements

• • Ability to sit, stand, and walk
  • Visual and auditory acuity for frequent use of computer,

 telephone, and occasional use of other office equipment

6.         Regulatory

            Abide by OSHA and HIPAA regulations

MINIMUM QUALIFICATIONS:

• Cooperative work attitude toward co-employees, management, patients, visitors, and physicians
• Ability to make logical decisions and solve problems
• Knowledge of CPT and ICD-10 coding applications
• GI knowledge a plus!

REQUIREMENTS:

• High school diploma or GED certificate
• Good communication skills
• Good computer skills
• Strong ethical and moral character references
• Pass background, drug, security check