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Insurance Pre-Certification Specialist
2 months ago
Insurance Pre-Certification Specialist
Job Summary:Imperial Health is seeking a skilled Insurance Pre-Certification Specialist to join our team. As a key member of our healthcare team, you will be responsible for ensuring that patients receive the necessary insurance verification and prior approvals prior to their arrival for surgery or procedure.
Key Responsibilities:- Verify patient insurance coverage and obtain prior approvals from payers.
- Communicate with physicians, mid-level providers, and clinical staff to obtain and understand clinical documentation requirements.
- Provide required clinical documentation to payers via phone, faxed forms, and/or website.
- Contact referring and other external providers as needed.
- Document authorization approvals and denials in Practice Management systems.
- Bachelor's degree or equivalent experience.
- Basic knowledge of managed care and insurance terminology.
- Excellent communication and customer service skills.
- Ability to work in a fast-paced environment and prioritize multiple tasks.
- Experience with obtaining prior authorizations.
- Knowledge of electronic medical records (EMRs) and Practice Management systems.
- Customer service experience in a healthcare-related environment.
