Precert Clerk

McAlester Regional Health Center Authority • McAlester, OK

10h

About The Position

The Precert Clerk plays a critical role in the healthcare administration process by ensuring that all necessary prior authorizations and precertifications are accurately obtained before patient services are rendered. This position is essential in facilitating smooth communication between healthcare providers, insurance companies, and patients to prevent delays in care and avoid claim denials. The clerk meticulously reviews patient information, insurance policies, and medical documentation to verify coverage and eligibility. By managing these administrative tasks efficiently, the Precert Clerk helps maintain compliance with insurance requirements.

Requirements

• High school diploma or equivalent.
• Experience working in a healthcare administrative or insurance verification role.
• Ability to work independently in a fast-paced environment.
• Proficiency with electronic health record (EHR) systems and Microsoft Office applications.
• Strong attention to detail and organizational skills.

Nice To Haves

• Two to five years of billing and collections experience, preferably in a hospital setting.
• Basic understanding of Microsoft Excel.
• Familiarity with HIPAA regulations and patient confidentiality standards.
• Excellent communication skills for interacting with patients, providers, and insurance representatives.
• Ability to multitask and manage time effectively in a fast-paced environment.

Responsibilities

• Review and process requests for prior authorizations and precertifications from healthcare providers.
• Verify patient insurance coverage and eligibility by communicating with insurance companies and utilizing electronic verification systems.
• Support other Patient Financial Services (PFS) associates in resolving accounts
• Collaborate with clinical staff to obtain the necessary medical documentation required for authorization submissions.
• Communicate with patients regarding the status of their authorization requests and provide guidance on insurance-related inquiries.
• Resolve issues using strong customer service skills, including identifying concerns, determining causes, explaining solutions, and following up to ensure resolution.

What This Job Offers

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