Pre Cert Rep

HH Health SystemHuntsville, AL

About The Position

The Pre-Certification Representative is responsible for obtaining approval from insurance companies for services that require referral, pre-certification or prior authorization. All job functions are performed in a manner that promotes the highest level of compliance with various legal, regulatory and accreditation requirements while maintaining all protected health information in manner that complies with HIPAA requirements.

Requirements

  • High School diploma or GED required; post-secondary education preferred.
  • Three years of medical insurance or medical billing experience required
  • One year of prior experience with pre-certifications preferred
  • Proficiency working with computer applications, including Word, Excel and EMR/Billing systems required.
  • Understanding of medical terminology and general medical billing processes, including accounts receivable required.
  • Basic understanding of medical coding required.
  • Broad understanding of insurance company requirements related to services that require referral, pre-certification or prior authorization required.
  • Ability to process a high volume of work in an accurate manner required.
  • Ability to communicate effectively both verbally and in writing required.
  • Effective work habits including, regular and prompt attendance, dependability, teamwork and initiative required.

Responsibilities

  • obtaining approval from insurance companies for services that require referral, pre-certification or prior authorization
  • performing all job functions in a manner that promotes the highest level of compliance with various legal, regulatory and accreditation requirements
  • maintaining all protected health information in manner that complies with HIPAA requirements

Benefits

  • medical
  • dental
  • vision
  • life insurance
  • flexible spending
  • short term and long term disability
  • several retirement account options with 401K organization match
  • nurse residency program
  • tuition assistance
  • student loan reimbursement
  • On-site training and education opportunities
  • Employee Discounts to phone providers, local restaurants, tickets to shows, apartment application and much more
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