Pre-Certification Specialist
Nexus Pain Center•Columbus, GA
•$16 - $22•Onsite
About The Position
The Precertification Specialist is responsible for obtaining prior authorizations for all procedural orders by successfully completing the authorization process.
Requirements
- High School Diploma or GED
- 1 years’ experience in a medical related field required
- Knowledge of procedure authorization and its direct impact on the practice’s revenue cycle
- Understanding of payer medical policy guidelines while utilizing these guidelines to manage authorizations effectively
- Proficient use of CPT and ICD-10 codes
- Excellent computer skills including Excel, Word, and Internet use
- Detail oriented with above average organizational skills
- Plans and prioritizes to meet deadlines
- Excellent customer service skills; communicates clearly and effectively
- Ability to multitask and remain focused while managing a high-volume, time-sensitive workload
Nice To Haves
- 1 year’s medical prior authorization experience preferred
Responsibilities
- Prioritize incoming authorization requests according to urgency
- Obtain authorization via payer website or by phone and follow up regularly on pending cases
- Initiate appeals for denied authorizations
- Respond to clinic questions regarding payer medical policy guidelines
- Confirm accuracy of CPT and ICD-10 diagnoses in the procedure order
- Other duties as assigned
Benefits
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
