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Precert Specialist

3 months ago

Savannah, United States Chatham Orthopaedic Associates Full time
Job DescriptionJob Description

I. Job Summary

Under the general supervision of the Revenue Cycle Manager, coordinates insurance authorizations. Communicates with patient account representative if patient has collections balance listed when authorization is requested. Communicates issues with physicians, medical assistants, surgery schedulers and patient account representatives.

II. Essential Job Responsibilities

  • Will work with our 3rd party vendor to make sure all authorizations are obtained and reviewed prior to all scheduled procedures, etc. MRI, CT, Surgeries, Epidurals
  • Coordinates with managed care and other carrier entities, physicians, physician office staff and patients to ensure a smooth coordination of patient services.
  • Obtains relevant information needed to initiate the authorization/pre-certification process from physicians or physicians’ staff (i.e. patient name, medical records, diagnosis code and description if needed to be started immediately.
  • Calls patients to schedule and / or confirm appointment as/if needed.
  • Enters authorization number into the practice management system and the EHR system with all pertinent information if necessary.

I.                   Minimal Qualifications

 Education:    High School Graduate

 Experience:    One to two years insurance experience.

 

II.                Independent Action

 Under general direction, functions independently in coordination of assigned duties.  Refers to team leader or director as appropriate on clarification of practice policy and procedure.

Company DescriptionOrthopaedic Surgical practiceCompany DescriptionOrthopaedic Surgical practice