AR Precertification Specialist

TOC- The Orthopaedic Center • Huntsville, AL

3d • Onsite

About The Position

The AR Precertification Specialist is responsible for ensuring all patients are pre-certified for office visits, consults, testing, and procedures according to each patient’s insurance company requirements. This involves monitoring patient schedules in the billing system, following specific insurance company procedures for approval (calling, faxing, emailing, online portals), and maintaining up-to-date knowledge of these requirements. The role also includes assisting other departments, notifying staff of approval/denial statuses, forwarding denials for review, and maintaining strict confidentiality. This position requires the ability to work under pressure, meet deadlines, and adapt to frequent schedule changes.

Requirements

• HS Diploma/GED required
• Coding, AR, Insurance reimbursement knowledge required.
• Ability to work under pressure and meet deadlines
• Outstanding organizational, verbal and writing skills
• Independent and highly motivated
• Initiative and self-discipline
• Proven positive, "teamwork" attitude in work history

Nice To Haves

• Three years insurance and/or billing experience preferred
• One year of healthcare experience preferred

Responsibilities

• Pre-certify all patients for office visits, consults, testing, and procedures as required by each patient’s insurance company by monitoring patient schedules in the billing system for each department.
• Follow insurance company pre-certification requirements for approval, such as calling, faxing, emailing, logging into their system online, etc.
• Assist accounts receivable, coding, registration, and insurance follow up staff on an as-needed basis.
• Answer requests from various departments regarding pre-cert requirements for various insurance companies.
• Reviews pre-cert requirements for insurance companies in timely manner to maintain up-to-date knowledge of requirements.
• Notifies appropriate staff on status of approval/denials.
• Forwards denials to manager and appropriate staff for further review and decision making.
• Maintains strict confidentiality.
• Performs related work as required.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED