Insurance Authorization and Pre-Certification Specialist

• This position is responsible for obtaining and completing all insurance pre-certifications and authorizations as required for various clinical procedures.
• Determines necessity for pre-certification and coordinates with insurance companies, patients and clinical staff to obtain information.
• Maintains complete and accurate documentation in patient charts.
• Develops and maintains effective relations with insurance companies, physicians and medical office staff.
• Must have proficient knowledge of insurance requirements, medical/clinical terminology, medical necessity associated with various clinical procedure codes and certification/referral work flow.
• This position requires the ability to work with minimal supervision.
• Monitor new patient report and maintain organized list with status of pre-certification process.
• Verify insurance eligibility and benefits via phone and/or internet access. Update insurance policy information.
• Check insurance payment policy for scheduled procedures and obtain prior authorization when required.
• Verify receipt of all necessary pre-authorization documents prior to procedure
• Communicate effectively with the facility in which the procedure will be performed as needed.
• Assign appropriate ICD and CPT codes pre-operatively based on documentation and booking slips.
• Notify primary care physician for managed care plans that require PCP authorization.
• Serve as a resource on insurance, billing and customer service for reception.
• Perform other duties or functions as assigned

Job Type: Full-time

Pay: $21.00 - $24.00 per hour

Application Question(s):

• Tell me about your experience with authorizing procedures

Education:

• High school or equivalent (Preferred)

Experience:

• Insurance verification: 1 year (Required)

Work Location: In person

Salary : $21 - $24