Openings >> Precertification Specialist - Full Time
Precertification Specialist - Full Time
Summary
Title:Precertification Specialist - Full Time
ID:1405
Department:PRD
Location:Main Clinic--Columbus, GA
Description
This company is an equal opportunity employer and makes employment decisions without regard to race, color, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. This company is a VEVRAA Federal Contractor.

Position Goal: Complete the precertification and prior authorization process by calling insurance companies, adjusters, and patients. Communicate the approval or denial of surgeries and/or tests effectively to physicians, physicians’ staff, and patients.

Position Responsibilities:
  • Responsible for obtaining precertification and prior authorization for patients scheduled for a surgical procedure and/or tests as ordered by physician
  • Responsible for obtaining all necessary information required to obtain precertification or prior authorization to include clinical dictation and test results
  • Provide accurate information to insurance companies based on test results, clinical dictation, etc.
  • Verify/re-verify insurance benefits and eligibility for each scheduled surgical procedure and/or test
Complete precertification and prior authorization process in a timely, efficient manner with respect to urgent requests.
Experience: Knowledge of medical insurance, medical terminology, and computer skills. Experience in a medical setting preferred.
Education: High School Diploma or GED.
Special Qualifications: Must be able to work independently and have a working knowledge of HIPAA.


 
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