Pre-Certification Clerk (SGR), Day Shift, Non-Acute Pre-Services
About The Position
Adventist HealthCare seeks to hire an experienced Pre-Certification Clerk for our Pre-Services Revenue Cycle department who will embrace our mission to extend God’s care through the ministry of physical, mental, and spiritual healing. As a Pre-Certification Clerk, you will: Assist with the verification and coordination of all pre-authorization for all Workers’ Compensation, Accident, or Personal Injury cases, along with obtaining pre-authorization for all MRI, CT, Bone Density, and any radiology exams that require pre-authorization Process incoming calls regarding these cases Maintain a professional attitude when speaking with payers, vendors, and agencies representing Adventist HealthCare Inform the front desk if a patient is coming for a procedure, if a co-payment, co-insurance, or deductible needs to be collected, or if there is an authorization or file for the patient Collect and obtain any clinical information needed to secure a pre-authorization for the patient's scheduled procedures Stay up to date on insurance protocols and inform the manager on any changes regarding authorization procedures Enter relevant information in the comments needed to assist the patient with obtaining the clinical information needed to secure pre-authorization or patient check-in Offer advice on how to obtain necessary authorizations/referrals or reschedule the patient (if needed)
Requirements
- High School Diploma or GED required
- 1-2 years of customer service experience
- 1-2 years of medical office experience
Responsibilities
- Assist with the verification and coordination of all pre-authorization for all Workers’ Compensation, Accident, or Personal Injury cases, along with obtaining pre-authorization for all MRI, CT, Bone Density, and any radiology exams that require pre-authorization
- Process incoming calls regarding these cases
- Maintain a professional attitude when speaking with payers, vendors, and agencies representing Adventist HealthCare
- Inform the front desk if a patient is coming for a procedure, if a co-payment, co-insurance, or deductible needs to be collected, or if there is an authorization or file for the patient
- Collect and obtain any clinical information needed to secure a pre-authorization for the patient's scheduled procedures
- Stay up to date on insurance protocols and inform the manager on any changes regarding authorization procedures
- Enter relevant information in the comments needed to assist the patient with obtaining the clinical information needed to secure pre-authorization or patient check-in
- Offer advice on how to obtain necessary authorizations/referrals or reschedule the patient (if needed)
Benefits
- Work life balance through nonrotating shifts
- Recognition and rewards for professional expertise
- Free Employee parking
- Medical, Prescription, Dental, and Vision coverage for employees and their eligible dependents effective on your date of hire
- Employer-paid Short & Long-Term Disability, Basic Life Insurance and AD&D, (short-term disability buy-up available)
- Paid Time Off
- Employer retirement contribution and match after 1-year of eligible employment with a 3-year vesting period
- Voluntary benefits include flexible spending accounts, legal plans, and life, pet, auto, home, long term care, and critical illness & accident insurance
- Subsidized childcare at participating childcare centers
- Tuition Reimbursement
- Employee Assistance Program (EAP) support
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
5,001-10,000 employees
