What are the responsibilities and job description for the AR Precertification Specialist position at TOC- The Orthopaedic Center?
Job Details
Description
Primary Responsibilities/Requirements:
Description
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
- 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
- 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