Precertification Specialist Assistant

Core Job Functions

• Compile and distribute daily service report.
• Review account to determine if certification is required.
• Work with physician offices and other hospital departments to make sure required certification is obtained and documented.
• Determines if authorization is required.
• Accurately documents account information.
• Maintain open communication and be available to component organizations and practitioner sites for consultation.
• Monitor various reports for precertification need.
• Perform initial review prior to date of service and concurrent review until precertification obtained.
• Communicate and collaborate with other departments to eliminate precertification denials.
• Review updated information from payers.
• Maintain updated files on specific payer requirements.