Precert/Insurance Specialist

Vanderbilt University Medical Center•Nashville, TN

6d•Onsite

About The Position

The Pre-Cert/Insurance Specialist verifies patient insurance eligibility with payers. Obtains and updates patient registration information. Obtains referral and authorizations/recertifications prior to patient date of service. Accurately documents referrals and authorizations in practice-management system.

Requirements

Relevant Work Experience
2 years
High School Diploma or GED

Nice To Haves

Provides guidance to entry level co-workers.
Continuously improves own skills by identifying development opportunities.
Seeks to understand colleagues' priorities, working styles and develops relationships across areas.
Openly shares information with others and communicates in a clear and courteous manner.
Invests time to understand the problems, needs of others and how to provide excellent service.
Seeks to understand issues, solves routine problems, and raises proper concerns in a timely manner.
Listens carefully to understand the issues and provides accurate information and support.
Checks work quality before delivery and asks relevant questions to meet quality standards.
Demonstrates basic knowledge of conditions that affect safety and reports unsafe conditions to the appropriate person or department.
Takes responsibility for completing assigned activities and thinks beyond standard approaches to provide high-quality work/service.
Displays understanding of how personal actions will impact departmental resources.
Uses accurate information and good decision making to consistently achieve results on time and without error.
Willingly proposes/accepts ideas or initiatives that will impact day-to-day operations by offering suggestions to enhance them.
Absorbs new technology quickly; understands when to utilize the appropriate tools and procedures to ensure proper course of action.
Embraces changes by keeping an open mind to changing plans and incorporates change instructions into own area of work.

Responsibilities

Verify insurance eligibility for new and returning patients, utilize Passport, telephone, internet tools as necessary to obtain verification of insurance coverage
Correct/update all coverage information in practice management system as necessary
Obtain all pre-certs and authorizations necessary to ensure collectivity of services performed
Work directly with clinic and central scheduling to assist and/or perform insurance verification, precerts, etc. for all walk in or STAT patients as responsible during business hours; train clinic staff to perform this function after hours
Answer patient/clinic calls in a professional manner on an as needed basis
Perform or assist with referring office in-services related to insurance/precert issues on an as needed basis
Organize and prioritize work appropriately
Take initiative in identifying/researching insurance payor issues, educate appropriate staff as necessary
Maintain confidentiality
Other duties as assigned