Certification Specialist - Utilization Management
About The Position
Certification review at Kettering Health Network hospitals. This includes any and all follow-up with insurance companies - approvals, denials, requests for additional information, assist in facilitating peer to peer reviews, and verification of discharge. Works closely with other disciplines - specifically Insurance Verification, Patient Access, Denials Management, Case Management and Social Services. Routinely works with large volume of patient accounts. Overview Kettering Health is a not-for-profit system of 13 medical centers and more than 120 outpatient facilities serving southwest Ohio. We are committed to transforming the health care experience with high-quality care for every stage of life. Our service-oriented mission is in action every day, whether it’s by providing care in our facilities, training the next generation of health care professionals, or serving others through international outreach.
Requirements
- Minimal high school graduate
Nice To Haves
- Associate Degree preferred
Responsibilities
- Certification review at Kettering Health Network hospitals.
- Follow-up with insurance companies - approvals, denials, requests for additional information
- Assist in facilitating peer to peer reviews
- Verification of discharge
- Works closely with other disciplines - specifically Insurance Verification, Patient Access, Denials Management, Case Management and Social Services.
- Routinely works with large volume of patient accounts.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
