Pre-Cert Coordinator

KureSmart Pain Management • Montgomery, AL

83d

About The Position

The Center for Pain is seeking a dedicated individual to join our dynamic team and contribute to providing exceptional care to our patients. We take pride in delivering top-notch healthcare services in a friendly and efficient environment, with a strong focus on a healthy work-life balance.

Requirements

• Previous experience in a pre-certification specialist role is a plus.
• Strong verbal and written communication skills, with the ability to interact professionally with patients, insurance companies, and internal team members.
• Proficient computer skills, comfortable using healthcare management software and other relevant tools.
• Exceptional organizational and multitasking abilities to handle a high volume of pre-certification requests efficiently.
• Attention to detail and accuracy in data entry.
• Familiarity with insurance policies, pre-authorization procedures, and medical terminology.
• Commitment to maintaining patient confidentiality and adhering to HIPAA regulations.

Responsibilities

• Conduct thorough verification of patient insurance coverage to determine pre-authorization requirements.
• Initiate and manage the pre-certification process for medical procedures, treatments, and medications, ensuring compliance with insurance guidelines.
• Maintain accurate and up-to-date records of pre-authorization approvals and denials, and communicate effectively with healthcare providers, patients, and insurance companies.
• Work closely with healthcare providers, billing, and administrative staff to gather necessary information for the pre-certification process.
• Monitor the status of pre-certification requests, promptly address any issues or denials, and appeal as necessary to ensure timely approval.
• Stay informed about changes in insurance regulations and policies, ensuring that pre-certification processes align with industry standards and compliance requirements.

Benefits

• Comprehensive health insurance coverage for employees.
• Competitive wage to recognize and reward your skills and dedication.
• Supportive and collaborative team environment.
• Focus on a balanced lifestyle and a healthy work environment.

What This Job Offers

• Industry: Ambulatory Health Care Services