Pre Cert Rep

HH Health System•Madison, AL

About The Position

The Pre-Certification Representative obtains approval from insurance companies for services that require referral, pre-certification, or prior authorization. All job functions are performed in a manner that promotes compliance with legal, regulatory, and accreditation requirements while protecting health information in accordance with HIPAA requirements.

Requirements

High school diploma or GED required.
Three years of medical insurance or medical billing experience required.
Proficiency with computer applications, including Word, Excel, and EMR/Billing systems.
Understanding of medical terminology and general medical billing processes, including accounts receivable.
Basic understanding of medical coding.
Broad understanding of insurance-company requirements for services requiring referral, pre-certification, or prior authorization.
Ability to process a high volume of work accurately.
Effective verbal and written communication skills.
Effective work habits, including regular and prompt attendance, dependability, teamwork, and initiative.

Nice To Haves

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

Responsibilities

Obtain insurance-company approval for services requiring referral, pre-certification, or prior authorization.
Perform job functions in compliance with applicable legal, regulatory, and accreditation requirements.
Maintain protected health information in compliance with HIPAA requirements.