Pre-Certification Specialist
The Cardiac & Vascular Institute · Gainesville, FL · 3 mo ago
On-siteInformation TechnologyFull-time
General Summary of Duties
Verifies insurance and obtains pre-certification authorization for hospital procedures, admissions and single procedures.
Essential Functions
- Verifies insurance and obtain authorizations for office based procedures
- Obtain authorizations for hospital procedures/sing/admissions
- Submit denied authorization requests for review
- Inform patients of financial obligations regarding co-pays, co-insurances, and deductibles
- Secure payment arrangements as needed regarding balances on accounts
- Communicate with practice and hospital staff regarding scheduling and authorization issues
- Scan/record required documentation regarding procedures, admissions, sing, and referrals
- Provide Business Office with information needed for proper coding and billing
- Works collaboratively with, and provides general support and back-up to Cath Lab Coordinator
Requirements
- Minimum 1 year insurance experience in a health care organization or specialty practice, preferably Cardiology-based
- Proficiency in standard EHR and Practice Management software is desired
- Proficiency in medical terminology with emphasis on Cardiology
- Working knowledge of insurance guidelines and terminology as well as CPT and ICD-9 coding
- Basic knowledge of electronic medical records retrieval system, computers, and the Internet
- Perform multiple tasks and meet deadlines
- Communicate effectively, efficiently, and professionally
- Knowledge of Intergy and Medical Manager systems highly preferred
Education and Experience
- High School graduate or GED