Pre-Certification Specialist
- 401(k) matching
- Dental insurance
- Health insurance
- Vision insurance
- Pre-Certification Management: Obtain pre-certification approvals from insurance companies for medical procedures, services, and medications.
- Documentation: Collect and review all required documentation to ensure compliance with insurance and regulatory requirements.
- Communication: Serve as a liaison between healthcare providers, insurance companies, and patients to facilitate smooth pre-certification processes.
- Follow-Up: Track and follow up on pending pre-certification requests to ensure timely approvals.
- Data Entry: Accurately enter and maintain pre-certification data in the electronic health record (EHR) or other relevant systems.
- Problem Resolution: Address and resolve any issues or denials related to pre-certification requests.
- Compliance: Stay informed about changes in insurance policies, procedures, and regulatory requirements to ensure compliance.
- Education: High School Diploma or equivalent required; Associate’s or Bachelor’s degree in healthcare administration, business, or a related field preferred.
- Experience: Minimum of [2-3] years of experience in a healthcare or insurance setting, with a focus on pre-certification or authorization processes.
- Skills:
- Strong knowledge of insurance pre-certification and authorization procedures.
- Excellent communication and interpersonal skills.
- Proficiency in using electronic health records (EHR) systems and other relevant software.
- Detail-oriented with strong organizational skills.
- Ability to work independently and handle multiple tasks simultaneously.
- Certifications: [Any specific certifications required or preferred, e.g., Certified Professional Coder (CPC)]
- Competitive salary and benefits package
- Comprehensive health, dental, and vision insurance
- Retirement savings plan with company match
- Opportunities for professional development and career growth
- Supportive and collaborative work environment
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