Medical Precertification Specialist

3 days ago


Princeton, New Jersey, United States Princeton Medical Group Inc Full time
Precertification Representative Job Description

We are seeking a detail-oriented and organized Precertification Representative to join our team at Princeton Medical Group, Inc. As a key member of our clinical operations team, you will play a crucial role in ensuring seamless patient care and efficient clinical operations.

Responsibilities:
  • Obtain precertifications for testing and procedures, ensuring timely and accurate communication with nursing staff.
  • Stay up-to-date on insurance company requirements and guidelines, relaying changes to staff as needed.
  • Utilize manual and computerized systems to obtain precertifications, track appeals, and complete follow-up tasks.
  • Coordinate peer-to-peer sessions and maintain logs to ensure historical patient and office activities are available for review.
  • Adhere to strict confidentiality guidelines and maintain a professional demeanor in all interactions.
Requirements:
  • Previous precertification experience and knowledge of insurance and precertification processes.
  • Excellent customer service skills for dealing with internal and external customers.
  • Knowledge of medical terminology and the ability to interpret medical charts.
  • 1 year of experience with ICD-10 billing processes (preferred).
Work Environment:

This is a full-time position in an office setting, Monday to Friday, 8:30 AM - 5:00 PM, with flexibility to adapt to changing schedules and overtime as required.

Princeton Medical Group, Inc. is an equal employment opportunity employer and welcomes applications from diverse candidates.



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