Pre-Certification Specialist (Surgery) (FT) - Remote

Optim • Savannah, GA

5d • Remote

About The Position

The Pre-certification Specialist is responsible for pre-certifying all surgeries prior to the day of surgery and following up with insurance companies if diagnoses or procedures change. This role requires familiarity with ICD-9 and CPT code books. The specialist will review patients' medical records, coordinate medical information with staff, and ensure insurance coverage is in place for surgeries. They will document all actions, maintain patient charts, answer patient inquiries about precert status, and maintain strict confidentiality of sensitive information.

Requirements

• Knowledge of medical terminology
• Knowledge of grammar, spelling, and punctuation to type correspondence
• Knowledge of insurance industry
• Skill in operating a computer and photocopy machine
• Ability to read, understand, and follow oral and written instruction
• Ability to maintain confidentiality of sensitive information
• Ability to sort and file materials correctly by alphabetic or numeric systems
• Ability to speak clearly and concisely
• Ability to establish and maintain effective working relationships with patients, employees, and the public
• High School Diploma or GED
• Successful completion of a course in Medical Terminology
• Minimum of one year experience in a Medical Office
• Computer Experience

Nice To Haves

• Familiarity with ICD-9 and CPT code books

Responsibilities

• Reviews patients’ medical records
• Works with medical and other staff in coordinating medical information and patient charts
• Responsible for pre-certing all surgeries, if required by ICD-9 code with the appropriate insurance company
• Follows-up with insurance companies ensuring that coverage is in effect
• Documents all actions and maintains permanent record in patients’ chart
• Answers patient questions and inquiries regarding the precert status of their surgeries
• Maintains strict confidentiality of sensitive information
• Performs related work as required

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED