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Pre-Cert Coordinator

2 months ago

West End, United States Pinehurst Medical Full time
Job DescriptionJob Description

Pinehurst Medical Clinic (PMC)

PMC is a recognized healthcare provider in the communities of Moore County, Lee County, Cumberland County, Chatham County, and the surrounding six counties. Locally owned and managed, PMC offers a broad range of primary and specialty care services to the communities we serve. The physicians and healthcare team of professionals at PMC share a commitment to patient-centered care that is physician-led and utilizes the latest advances in medical technology. This combination of leading-edge medicine and deep compassion for the people we serve has been a hallmark of PMC since 1952. PMC consists of over 130 providers, approximately 750 employees, and 16 locations.


Benefits to support you and your family:

PMC is proud to support the total health and well-being of our team members so they can thrive personally and professionally. That’s why, as part of the PMC team, you’ll have a package of benefits that covers your health, well-being, family, and future. For more information regarding our benefits, click here to watch our benefit video or click here for our benefits overview guide.

What will you do as a PMC Precertification Coordinator

As a PMC Precertification Coordinator, you will serve as an essential part of the patient’s experience by providing a personal and unified effort to obtain prior authorization for medical services/procedures. By assisting patients, providers, and staff with questions they might have regarding prior authorization of services/procedures.

A day in the life of a PMC Precertification Coordinator may include:

  • Obtain prior authorization for scheduled procedures.
  • Respond to telephone and written inquiries regarding precertification and insurance-related matters.
  • Assists with denial resolutions, with direct participation with management and other staff members.
  • Prepare any telephone, written, or online pre-certification requests providing detailed explanations.
  • Handle changes in patient information relating to registration information including insurance/guarantor information, as needed as part of the precertification process.
  • Document all transactions, telephone contacts, etc. in the individual PMC patient’s account/medical record.
  • Being a key piece in the PMC mission by providing the highest quality of care to our patients and the communities we serve.

What we can offer

PMC is proud to support the total health and well-being of our team members so they can thrive personally and professionally. That’s why, as part of the PMC team, you’ll have a package of benefits that covers your health, well-being, family, and future. For more information regarding our benefits click here Benefits Information

Required Qualifications

  • High school diploma or general education degree (GED); or one to three months related experience and/or training; or equivalent combination of education and experience.

Experience

  • One to two years of experience in a medical office setting is preferred.
  • CPT and ICD-10 experience required.



The Pinehurst Medical Clinic is an equal opportunity employer and fully supports and maintains compliance with all state, federal, and local regulations and provides equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law.