Pre Certification Assistant - COPC Sports, Spine & Joint

Central Ohio Primary Care • Westerville, OH

12h • Onsite

About The Position

This position works to obtain approvals for orders by submitting completed clinical information to insurance companies and their vendors. Full Time/Benefits Eligible Monday-Friday - 8:00am-4:30pm Westerville, OH ESSENTIAL FUNCTIONS AND RESPONIBILITIES: Process routine orders in the date received in a timely manner. Identify urgent orders and process orders the same day received. Verify insurance eligibility, complete pre-certifications as needed. Compile all clinical data needed to support the criteria set forth by each payor’s guidelines. Communicate with the ordering provider if additional clinical clarification or information is needed before submitting request. Follow up on pending cases, respond to assigned telephone encounters, accurately document all activity of the case. Collaborate with team to distribute workload and prioritize department needs. Attend department and other related meetings.

Requirements

• High school diploma
• Excellent verbal & written communication skills
• Knowledge of Microsoft Teams, Word, Excel and Outlook
• Ability to execute job duties with precision and attention to detail
• Ability to work both independently and together as a team
• Ability to prioritize and organize work efficiently to complete work timely
• Ability to accommodate and embrace ongoing change in systems, insurance guidelines and process
• Strong time management skills
• Possess a positive attitude
• Possess strong problem solving, critical thinking skills

Nice To Haves

• Some college courses
• Minimum 2 years Pre-certification experience in a healthcare setting.

Responsibilities

• Process routine orders in the date received in a timely manner.
• Identify urgent orders and process orders the same day received.
• Verify insurance eligibility, complete pre-certifications as needed.
• Compile all clinical data needed to support the criteria set forth by each payor’s guidelines.
• Communicate with the ordering provider if additional clinical clarification or information is needed before submitting request.
• Follow up on pending cases, respond to assigned telephone encounters, accurately document all activity of the case.
• Collaborate with team to distribute workload and prioritize department needs.
• Attend department and other related meetings.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED