AR Precertification Specialist

The Orthopaedic Center • Huntsville, AL

2d • Onsite

About The Position

The AR Precertification Specialist is responsible for pre-certifying all patients for office visits, consults, testing, and procedures according to each patient’s insurance company requirements. This involves monitoring patient schedules in the billing system for each department and following specific insurance company pre-certification procedures, which may include calling, faxing, emailing, or logging into online portals. The specialist will also assist accounts receivable, coding, registration, and insurance follow-up staff as needed, and respond to requests from various departments regarding pre-certification requirements. Maintaining up-to-date knowledge of insurance company pre-certification requirements is crucial, as is notifying appropriate staff of approval or denial statuses and forwarding denials for further review. The role requires maintaining strict confidentiality and performing related duties as needed.

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