Medical Precertification Specialist
5 days ago
Princeton Medical Group Inc. is a private medical practice with over 30 providers and 8 medical specialties. Our mission is to deliver exceptional medical care with compassion.
Job SummaryWe are seeking a highly skilled Medical Precertification Specialist to join our dynamic team. As a key member of our clinical operations, you will be responsible for obtaining precertifications for testing and procedures, communicating with nursing staff, and staying up-to-date on insurance company requirements and guidelines.
Responsibilities- Obtain precertifications for testing and procedures in a timely and accurate manner.
- Communicate effectively with nursing staff to ensure seamless patient care.
- Stay actively informed about changes in insurance company requirements and guidelines.
- Use manual and computerized systems to obtain precertifications.
- Track appeals for denied requests to insurance companies.
- Complete follow-up tasks related to active and pending reviews.
- Coordinate peer-to-peer sessions as needed.
- Establish and maintain logs to ensure historical patient and office activities are available for review.
- Adhere to strict confidentiality guidelines.
- Previous experience in precertification or a related field.
- Excellent customer service skills for dealing with internal and external customers.
- Knowledge of insurance and precertification processes.
- Knowledge of medical terminology and the ability to interpret medical charts.
- 1 year of experience with ICD-10 billing processes (preferred).
This is a full-time position in a medical office setting. The ideal candidate will have excellent communication and organizational skills, with the ability to work in a fast-paced environment.
BenefitsPrinceton Medical Group Inc. offers a comprehensive benefits package, including personal medical and dental insurance, 401(k) and profit-sharing plan, life insurance, and paid time off.
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