Pre Certification Specialist - Orthopedics
ProMedica•Toledo, OH
•Onsite
About The Position
When ProMedica patients prepare for orthopaedic surgeries and injections, the Pre-Certification Specialist performs prior authorization and certification for the services with payers. You will have a general understanding of coding for surgeries and injections and keep a working knowledge of medical criteria relating to prior authorization requirements by third-party payers.
Requirements
- Associate degree or 5 years of Billing/Insurance Verification experience
- Familiarity with ICD10 and CPT codes applicable to services rendered
- 5 years of relatable or equivalent experience in medical office
Nice To Haves
- Specific knowledge of medical payers
Responsibilities
- Performs prior authorization and certification for orthopaedic surgeries and injections with payers.
- Maintains a general understanding of coding for surgeries and injections.
- Keeps a working knowledge of medical criteria relating to prior authorization requirements by third-party payers.
Benefits
- Flexible benefits that include compensation and programs to help you take care of your family, your finances and your personal well-being.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
