Surgery Precertification Coordinator

3 weeks ago


Houston, Texas, United States OrthoLoneStar PLLC Full time
Surgery Precertification Specialist Job Description

I. General Summary
As a key member of the OrthoLoneStar PLLC team, the Surgery Precertification Specialist plays a vital role in ensuring seamless patient care. This position is responsible for obtaining surgery pre-authorizations, processing patient payments, and providing exceptional customer service to all stakeholders.

II. Principal Responsibilities and Tasks
1. Obtain surgery authorization for procedures requested by physicians in a timely and efficient manner.
2. Analyze patient insurance plans to determine financial responsibility, verifying insurance benefits and eligibility.
3. Collect surgery deposits from patients in a timely manner, maintaining confidentiality and security of cash, checks, and credit cards.
4. Provide positive and helpful assistance to patients, adjusters, and office staff, answering various questions and resolving issues.
5. Receive and screen visitors and telephone calls, providing basic information and support.
6. Perform other duties and projects as assigned by management.

III. Education and Experience
1. High School Diploma or equivalent (GED) is required.
2. Relevant front-desk and customer-related experience is necessary.
3. 1-3 years of experience within a healthcare environment or relevant equivalent is required.
4. Prior experience in customer service, knowledge of different insurance plans, and the ability to research complex issues are essential.

IV. Knowledge, Skills and Abilities
1. Ability to interact with personnel of all levels within the organization and work within a fast-paced team environment.
2. Maintain a culture of excellent customer service, open and friendly staff relations, and an approachable demeanor with all levels of staff.
3. Interpersonal skills, customer orientation, and an outgoing and pleasant demeanor are required.
4. Prior experience and demonstrated competence with patient or customer information systems are necessary.
5. Excellent verbal, written, and interpersonal communication skills are required to communicate effectively with all levels of hospital staff, patients, visitors, and staff.
6. Advanced reading, data entry, and computer skills are necessary.
7. Knowledge of HIPAA regulations and maintaining confidentiality of patient and client information is essential.

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