Pre Cert Rep - Patient Accounting - FT - 1st Shift

About the role

The Pre-certification Representative is responsible for obtaining approval from insurance companies for services that require referral, pre-certification or prior authorization. All job functions are performed in a manner that promotes the highest level of compliance with various legal, regulatory and accreditation requirements while maintaining all protected health information in a manner that complies with HIPAA requirements.

Responsibilities

• Obtain approval from insurance companies for services requiring referral, pre-certification or prior authorization.
• Maintain compliance with legal, regulatory, and accreditation requirements.
• Ensure confidentiality and protection of patient information under HIPAA guidelines.
• Work with computer applications, including Microsoft Office and EMR/Billing systems.
• Understand and apply insurance company requirements related to services requiring referral, pre-certification or prior authorization.
• Communicate effectively both verbally and in writing.
• Manage a high volume of work accurately and efficiently.
• Compile and analyze data as needed.

Requirements

• High school diploma or GED.
• Post-secondary education preferred.
• Three years of medical insurance or medical billing experience required.
• Two to three years of prior experience with pre-certifications preferred.

Additional Skills/Abilities

• Proficiency working with computer applications, including Microsoft Office and EMR/Billing systems.
• Broad understanding of insurance company requirements related to services that require referral, pre-certification or prior authorization.
• Effective work habits including regular and prompt attendance, dependability, teamwork, and initiative.
• Excellent verbal and written communication skills.
• Ability to type 35 wpm with 90% accuracy.
• Ability to manage a high volume of work in an accurate manner.
• Ability to communicate effectively both verbally and in writing.
• Positive attitude and ability to work in a fast-paced environment.
• Effective time management and organizational skills.
• Self-discipline to impose structure onto Registration personnel.
• Disposition of responsibility, assuming personal accountability for work and actions.
• Problem-solving ability, thinking through issues with incomplete data.
• Empathy, relating to the feelings and perspectives of others.
• Individualized perception, being aware and attentive to individual differences.
• Persuasive ability, able to persuade others in a logical manner.
• Ability to take charge and lead.

Qualifications

• High school diploma or GED.
• Post-secondary education preferred.
• Three years of medical insurance or medical billing experience required.
• Two to three years of prior experience with pre-certifications preferred.

Skills

• Proficiency working with computer applications, including Microsoft Office and EMR/Billing systems.
• Broad understanding of insurance company requirements related to services that require referral, pre-certification or prior authorization.
• Effective work habits including regular and prompt attendance, dependability, teamwork, and initiative.
• Excellent verbal and written communication skills.
• Ability to type 35 wpm with 90% accuracy.
• Ability to manage a high volume of work in an accurate manner.
• Ability to communicate effectively both verbally and in writing.
• Positive attitude and ability to work in a fast-paced environment.
• Effective time management and organizational skills.
• Self-discipline to impose structure onto Registration personnel.
• Disposition of responsibility, assuming personal accountability for work and actions.
• Problem-solving ability, thinking through issues with incomplete data.
• Empathy, relating to the feelings and perspectives of others.
• Individualized perception, being aware and attentive to individual differences.
• Persuasive ability, able to persuade others in a logical manner.
• Ability to take charge and lead.

Benefits

We offer a comprehensive benefits package including:

• Medical, dental, and vision insurance.
• Life insurance.
• Short-term and long-term disability coverage.
• Retirement plans with employer matching contributions.
• Nurse residency program.
• Tuition assistance.
• Student loan reimbursement.
• On-site training and education opportunities.
• Employee discounts.

Learn more about our benefits at Healthcare System's Careers Website.

Pay

Compensation is commensurate with experience.

Schedule

Hours are typically full-time, but may vary based on department needs.

About Us

Huntsville Hospital was recently named Best Regional Hospital and #2 in Alabama by U.S. News & World Report. With 971 beds, a specialized Orthopedic & Spine Tower, a Level III Regional Neonatal ICU, and the largest Emergency Department and Level 1 Trauma Center in the state with our own specialized Red Shirt Trauma Program, there are many opportunities to apply your knowledge and skills. We are a certified Primary Stroke Center and named "One of the Top 100 Hospitals in the Nation with Great Heart Programs." From six cath labs and four EP labs to multiple medical and step-down units, you can continually grow your skillset!

We offer a training center on campus for continuing education, Shared Governance Program, Clinical Ladder for professional development, The Daisy Award, and if you are a new grad, a Nurse Residency Program to help you transition from student to professional nurse. We care about you and your well-being by offering an excellent benefits package, childcare, health and wellness programs, an onsite employee pharmacy, a free health clinic, tuition assistance, and much more. We are committed to creating a diverse environment and proud to be an equal opportunity employer. We are a partner to the U.S. Army’s Partnership for Your Success (PaYS) program.

Learn more about our benefits at Healthcare System's Careers Website.