Role OverviewThe Pre-Certification Specialist is responsible for the completion of pre-certification, prior authorization and notification for third party and government payers for all pre-scheduled elective inpatient/outpatient procedures and diagnostic testing.
What You Will Do
The Pre-Certification Specialist must demonstrate Customer Focus and expert Functional/Technical Skills while providing pre-certification evaluation of each scheduled inpatient or outpatient patient case.
Why It Might Be a Fit
The Pre-Certification Specialist must maintain excellent customer service standards at all times in order to effectively communicate with physicians, physician offices, insurance representatives, patients, and co-workers.
Requirements
- High school diploma or GED required
- Associate Degree in related healthcare or business field preferred
- Medical Terminology Certification preferred
- Two years of Patient Access, Health Information Management, Physician Office, Billing, Collections or Compliance experience required
- Two Years of previous insurance experience and/or pre-certification experience preferred
]]>