Pre-Cert Coordinator
- Great Lifestyle: We understand the importance of a balanced lifestyle, and our clinic promotes a healthy and positive work environment.
- Competitive Wage: We offer a competitive package to recognize and reward your skills and dedication.
- Fantastic Team: Join a group of fellow employees who are not just colleagues but a supportive and collaborative team.
- Efficiency: Despite our busy schedule, we pride ourselves on being highly efficient, ensuring a streamlined and organized work environment.
- Exceptional Physicians: Work alongside experienced and compassionate physicians who are leaders in pain management, providing an excellent learning environment.
- Health Insurance Benefits: Comprehensive health insurance coverage for employees, ensuring peace of mind for you and your family.
- Insurance Verification: Conduct thorough verification of patient insurance coverage to determine pre-authorization requirements.
- Pre-Certification Processing: Initiate and manage the pre-certification process for medical procedures, treatments, and medications, ensuring compliance with insurance guidelines.
- Documentation: Maintain accurate and up-to-date records of pre-authorization approvals and denials, and communicate effectively with healthcare providers, patients, and insurance companies.
- Collaboration: Work closely with healthcare providers, billing, and administrative staff to gather necessary information for the pre-certification process.
- Follow-Up: Monitor the status of pre-certification requests, promptly address any issues or denials, and appeal as necessary to ensure timely approval.
- Compliance: Stay informed about changes in insurance regulations and policies, ensuring that pre-certification processes align with industry standards and compliance requirements.
- Previous experience in a pre-certification specialist role is a plus.
- Strong verbal and written communication skills, with the ability to interact professionally with patients, insurance companies, and internal team members.
- Proficient computer skills, comfortable using healthcare management software and other relevant tools.
- Exceptional organizational and multitasking abilities to handle a high volume of pre-certification requests efficiently.
- Attention to detail and accuracy in data entry.
- Familiarity with insurance policies, pre-authorization procedures, and medical terminology.
- Commitment to maintaining patient confidentiality and adhering to HIPAA regulations.
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