Pre-Certification Representative

3 weeks ago

Miamisburg, Ohio, United States Kettering Health Full time

Job Summary:

This position is responsible for facilitating the patient intake process by obtaining and validating precertifications on scheduled outpatient services, sleep studies, radiation oncology, elective scheduled surgeries, and other services as needed.

The representative reviews insurance verification and obtains/validates precertification information when required at each encounter to ensure accurate and complete billing.

This role requires exceptional customer service skills, with a focus on providing a delightful experience for patients, providers, and other departments.

Key Responsibilities:

  1. Obtain and validate precertifications for scheduled outpatient services, sleep studies, radiation oncology, elective scheduled surgeries, and other services as needed.
  2. Review insurance verification and obtain/validate precertification information when required at each encounter.
  3. Provide exceptional customer service to patients, providers, and other departments.
  4. Maintain knowledge of Pre-Access and Kettering Health offerings to provide exceptional services.
  5. Handle sensitive matters courteously and with professionalism.
  6. Adhere to department policies and procedures and HIPAA regulations.

Requirements:

  1. Ability to articulate the mission of Kettering Health and Pre-Access.
  2. Strong attention to detail and ability to take initiative to resolve inquiries and issues.
  3. Demonstrated personal commitment to promoting and providing excellent customer service.
  4. Demonstrated interpersonal, customer relations, and communication skills.
  5. Ability to listen and document notes simultaneously.
  6. Ability to read, analyze, and interpret verbal and written instruction.
  7. Maintains high energy and positive attitude.
  8. Ability to remain calm under pressure.
  9. Adapts to change and balances multiple priorities in a fast-paced environment.
  10. Demonstrates regular, consistent, and punctual attendance.
  11. Effective communicator in English, both orally and in writing.
  12. Computer proficiency in Microsoft Office Suite programs and basic keyboard typing skills.

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