Pre Cert Rep

HH Health System•Madison, AL

3d•Onsite

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
Three years of medical insurance or medical billing experience required
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.

Nice To Haves

Post-secondary education preferred
One year of prior experience with pre-certifications preferred

Responsibilities

Obtaining approval from insurance companies for services that require referral, pre-certification or prior authorization.
Promoting the highest level of compliance with various legal, regulatory and accreditation requirements.
Maintaining all protected health information in a 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!
Childcare
Health and wellness programs
Onsite employee pharmacy
Free health clinic