Pre-Certification Coordinator I (Remote) - Department of Medicine

Position Summary

Position performs varied professional services to ensure medical/surgical and diagnostic/ancillary services are accomplished in an efficient manner and that reimbursement is maximized through required interaction with third-party payers.

Primary Duties & Responsibilities

• Initiates and facilitates pre-determination process.
• Contacts appropriate insurance companies for benefit verification and pre-certification of surgical and nonsurgical procedures; notifies financial counselor for pre-payment of un-coded services.
• Supplies all documentation required during pre-certification process to insurance companies.
• Maintains daily surgery/procedure schedule for department faculty; maintains open communication with physicians and their assistants regarding their schedules.
• Maintains written log of all pre-certifications in process; notifies hospital utilization/billing department of pre-certification.
• Documents when pre-certification is received from insurance companies.
• Performs other duties as assigned.

Working Conditions

Normal working environment. Patient care setting.

Physical Effort

Typically sitting at desk or table. Repetitive wrist, hand or finger movement.

Equipment

Office equipment.

Required Qualifications

• High school diploma or equivalent high school certification or combination of education and/or experience.
• Medical Office Setting: 2 years.

Preferred Qualifications

• Some college or associate degree.
• RHIT and/or CPC certification, coding experience.
• Excellent communication, interpersonal and organizational skills required.
• Experience interacting with managed care plans, insurance companies and third-party payers.
• Ability to work with internal and external customers, including physicians, nurses, patients and families.

Skills

• Communication
• External Customers
• Insurance
• Internal Customers
• Interpersonal Communication
• Managed Care
• Medical Insurance Coding
• Organizing
• Third Party Payers

Salary Range

$21.33 - $31.98 / Hourly