Pre-Certification Coordinator 2

The Ohio State University

6d•Remote

About The Position

Revenue Cycle Pre-certification verifies benefits for outpatient, inpatient and ambulatory surgery services, as well as obtaining prior authorization for visits, procedures and hospitalizations, pre-approval, PCP referrals, predeterminations for all electively scheduled admissions, outpatient surgeries and other designated outpatient visits. The Pre-certification Coordinator is an expert in product, process or service line area (physician appointment scheduling, OR/admission, full service scheduling; pre-registration and registration; insurance verification, and patient liability determination and communication). This position is responsible for providing consumers (clinical staff and patients) with accurate, up-to-date information regarding products, services and general procedures. Schedule return appointments and/or other appointments as assigned. Assures accurate appointment, demographic and insurance information is gathered to support clinical and financial needs including changes to insurance or other patient information. Provides support to physicians and consumer by coordinating their requests and satisfying their needs in one transaction. Solves routine and complex customer problems and knows where to direct customers to address specific questions. Communicates regularly with clinical staff, medical secretaries and staff within the product/service line to ensure customer and department staff needs are met. Always creates a positive first impression. Must be able to use a variety of software packages which include the Electronic Medical record, scheduling and registration systems, ABN, eligibility, document management software, and etc.

Requirements

High School diploma or GED.
1 year of relevant experience required.

Nice To Haves

Certification or vocational training may be preferred.
2-4 years of relevant experience preferred.

Responsibilities

Verifies benefits for outpatient, inpatient and ambulatory surgery services.
Obtains prior authorization for visits, procedures and hospitalizations, pre-approval, PCP referrals, predeterminations for all electively scheduled admissions, outpatient surgeries and other designated outpatient visits.
Provides consumers (clinical staff and patients) with accurate, up-to-date information regarding products, services and general procedures.
Schedules return appointments and/or other appointments as assigned.
Ensures accurate appointment, demographic and insurance information is gathered to support clinical and financial needs, including changes to insurance or other patient information.
Supports physicians and consumers by coordinating their requests and satisfying their needs in one transaction.
Solves routine and complex customer problems and directs customers to appropriate resources for specific questions.
Communicates regularly with clinical staff, medical secretaries, and staff within the product/service line to ensure customer and department staff needs are met.
Creates a positive first impression.
Utilizes a variety of software packages including Electronic Medical Record, scheduling and registration systems, ABN, eligibility, and document management software.