Precertification Rep - DOC

Huntsville Hospital Health System•Decatur, AL

About The Position

The Orthopaedic Center is seeking a highly motivated AR Precertification Specialist for its affiliate, DOC Orthopaedic and Sports Medicine. This full-time position averages 40 hours per week. The specialist pre-certifies patients for office visits, consultations, testing, and procedures as required by each patient’s insurance company, monitoring patient schedules in the billing system for each department. The role also supports accounts receivable, coding, registration, and insurance follow-up staff as needed, while maintaining strict confidentiality and performing other duties as assigned.

Requirements

High school diploma or GED.
Knowledge of coding, accounts receivable, and insurance reimbursement.
Ability to work under pressure.
Outstanding organizational and writing skills.
Ability to speak clearly and concisely.
Independent, self-starting, and highly motivated.
A positive teamwork attitude demonstrated in work history.

Nice To Haves

Three years of insurance and/or billing experience preferred.
One year of healthcare experience preferred.

Responsibilities

Pre-certify patients for office visits, consultations, testing, and procedures according to insurance company requirements.
Monitor patient schedules in the billing system for each department.
Obtain pre-certification approvals by contacting insurance companies by phone, fax, email, or online systems.
Assist accounts receivable, coding, registration, and insurance follow-up staff as needed.
Respond to requests from various departments regarding insurance-company pre-certification requirements.
Review insurance-company pre-certification requirements promptly to maintain up-to-date knowledge.
Notify appropriate staff about approval and denial status.
Forward denials to the manager and appropriate staff for review and decision-making.
Maintain strict confidentiality.
Perform other duties as assigned.