Medical Precertification Representative

4 days ago


Sandy Springs, United States CARDIOLOGY OF ATLANTA, P.C Full time

Job Description

Cardiology of Atlanta needs a Medical Precertification Representative to join our revenue cycle team. This role will guarantee that all in-office cardiac testing and hospital catheterization patients are screened for policy guidelines and any needed authorizations/pre-certifications are obtained from managed care and Medicare Advantage plan payors prior to the scheduled appointment.


Role and Responsibilities

· Processes incoming requests for authorizations from physicians/clinic RNs

· Verifies patient benefits for cardiac testing/procedures and determines the need for authorization/pre-certification

· Documents insurance benefits and authorizations within the EMR

· Works closely with clinical coordinator and/or practice administrator to problem-solve on any denial of services

· Verifies schedules daily that all tests have been screened and worked

· Places follow up calls to insurance plan to obtain approval status

· Scans authorization documents into EMR


Qualifications

The ideal candidate will be highly organized, works effectively and collaboratively in a team environment, and possesses strong communication skills.

High School Diploma or equivalent education and a minimum of two (2) years related experience in Registration and/or Insurance Verification in a medical setting is required.

Experience in Cardiology is preferred but will consider training a candidate with at minimum of 3 years’ verifiable experience


Details

Job Type: Full-time position

Schedule: Monday-Friday, 8:00am -4:30pm

Location: In-person only

Benefits:

  • 401(k)
  • Health/Dental/Vision insurance
  • Life insurance
  • Paid time off

Ability to commute/relocate:

  • Atlanta, GA 30328: Reliably commute or planning to relocate before starting work (Required)

Experience in medical precertification: 2 years (Preferred)




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