Precertification Specialist II
5 days ago
Location:
1340 Broad Ave Suite 440 Gulfport, MS 39501.
Job Summary:
The Precertification Specialist II is responsible for overseeing the completion of authorizations. The Specialist acts as the liaison between providers, physicians, insurance companies, billing department, and utilization review companies to ensure the initiation and/or completion of all payers requiring precertification
Job Description:
- Obtains, verifies, and assists in the completion of authorization
- Monitors a listing of scheduled procedures to begin and complete the authorization process
- Reviews clinical records for supporting documentation and submits to obtain authorization
- Documents accounts and charts with updated authorization statuses based on final payer responses
- Completes authorizations with no more than five incomplete authorizations within a one-year period
- Receives communication from providers and/or the provider's staff when procedures are ordered for outside facilities
- Acts as a liaison with physician offices, insurance companies, and utilization review companies
- Reports denials and works with providers to appeal as the providers sees fit
- Gathers information requested by providers and assists by prefilling forms
- Communicates with providers regarding incomplete documentation, peer-to-peer review requests, denials and appeals
- Works in conjunction with billing departments to obtain authorizations post service initiation
- Examines past procedures for performed testing with missing authorizations
- Submits clinical documentation for retroactive or upgraded authorizations
- Collaborates with billing to obtain authorization when denials or audits are necessary due to final payer response
Required Qualifications:
Education: High School Diploma or GED equivalent.
Experience: Two (2) years of experience with precertification and insurance verification in a hospital or healthcare setting OR completion of LPN/RN program.
-
Armorer (OBMLS Specialist II)
4 days ago
Gulfport, Mississippi, United States DMS International Full timeData Management Services, Inc. (dba: DMS International) is a professional services firm headquartered in Silver Spring, Maryland, with work locations throughout the continental United States. We prepare managers and executives to lead their workforce through customized learning solutions that drive the standards of an ever-changing world. We build creative,...
-
Armorer OBMLS Specialist II
7 days ago
Gulfport, MS, United States DMS International Full time[] Data Management Services, Inc. (dba: DMS International) is a professional services firm headquartered in Silver Spring, Maryland, with work locations throughout the continental United States. We prepare managers and executives to lead their workforce through customized learning solutions that drive the standards of an ever-changing world. We build...
-
Armorer OBMLS Specialist II
2 weeks ago
Gulfport, MS, United States DMS International Full time[] Data Management Services, Inc. (dba: DMS International) is a professional services firm headquartered in Silver Spring, Maryland, with work locations throughout the continental United States. We prepare managers and executives to lead their workforce through customized learning solutions that drive the standards of an ever-changing world. We build...
-
Armorer OBMLS Specialist II
15 hours ago
Gulfport, MS, United States DMS International Full time[] Data Management Services, Inc. (dba: DMS International) is a professional services firm headquartered in Silver Spring, Maryland, with work locations throughout the continental United States. We prepare managers and executives to lead their workforce through customized learning solutions that drive the standards of an ever-changing world. We build...
-
Gulfport, MS, United States DMS International Full time[] Data Management Services, Inc. (dba: DMS International) is a professional services firm headquartered in Silver Spring, Maryland, with work locations throughout the continental United States. We prepare managers and executives to lead their workforce through customized learning solutions that drive the standards of an ever-changing world. We build...
-
Gulfport, MS, United States DMS International Full time[] Data Management Services, Inc. (dba: DMS International) is a professional services firm headquartered in Silver Spring, Maryland, with work locations throughout the continental United States. We prepare managers and executives to lead their workforce through customized learning solutions that drive the standards of an ever-changing world. We build...
-
Gulfport, MS, United States DMS International Full time[] Data Management Services, Inc. (dba: DMS International) is a professional services firm headquartered in Silver Spring, Maryland, with work locations throughout the continental United States. We prepare managers and executives to lead their workforce through customized learning solutions that drive the standards of an ever-changing world. We build...
-
Gulfport, MS, United States DMS International Full time[] Data Management Services, Inc. (dba: DMS International) is a professional services firm headquartered in Silver Spring, Maryland, with work locations throughout the continental United States. We prepare managers and executives to lead their workforce through customized learning solutions that drive the standards of an ever-changing world. We build...
-
Armorer/Emergency Medical Technicians
1 week ago
Gulfport, MS, United States DMS International Full timeData Management Services, Inc. (dba: DMS International) is a professional services firm headquartered in Silver Spring, Maryland, with work locations throughout the continental United States. We prepare managers and executives to lead their workforce through customized learning solutions that drive the standards of an ever-changing world. We build creative,...
-
Armorer/Emergency Medical Technicians
2 weeks ago
Gulfport, MS, United States DMS International Full timeData Management Services, Inc. (dba: DMS International) is a professional services firm headquartered in Silver Spring, Maryland, with work locations throughout the continental United States. We prepare managers and executives to lead their workforce through customized learning solutions that drive the standards of an ever-changing world. We build creative,...
-
Armorer/Emergency Medical Technicians
4 hours ago
Gulfport, MS, United States DMS International Full timeData Management Services, Inc. (dba: DMS International) is a professional services firm headquartered in Silver Spring, Maryland, with work locations throughout the continental United States. We prepare managers and executives to lead their workforce through customized learning solutions that drive the standards of an ever-changing world. We build creative,...
