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
