Role OverviewAs an essential member of the Revenue Cycle team, Pre-cert Specialists ensure authorizations for outpatient testing, ambulatory and inpatient services are obtained before services are rendered.
What You Will Do
Verifies and pre-certifies inpatient and outpatient services, verifies and allocates insurance plans, submits timely notifications and clinical documentation, and communicates with providers and payers.
Why It Might Be a Fit
The successful completion of tasks performed by this position, directly impacts denials and reimbursement from third party payers.
Requirements
- High School Equivalent / GED (Required)
- 3+ years experience in hospital Revenue Cycle/healthcare, working with insurance companies/third-party payers or related experience (Required)
- Knowledge of managed care insurance requirements (Required proficiency)
- Notable client service, communication and relationship building skills (Required proficiency)
- Ability to function independently and as a team player in a fast-paced environment (Required proficiency)
- Strong written and verbal communication skills (Required proficiency)
- Professional demeanor (Required proficiency)
- Detail-oriented and organized, with good analytical and problem solving ability (Required proficiency)
- Demonstrated ability to use PCs, Microsoft Office suite, and general office equipment (i.e. printers, copy machine, multi-line phone, FAX machine, etc.) (Required proficiency)
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