PRECERTIFICATION SPECIALIST

FIRST UROLOGY P S C•Jeffersonville, IN

3d•Onsite

About The Position

This role is to verify a patient's insurance benefits and obtain pre-authorization for medical services or procedures, ensuring coverage before the service is rendered. Key duties include verifying eligibility, gathering necessary information from physicians, communicating with insurance companies, documenting all details, and informing patients about their coverage. This role requires strong communication, attention to detail, and knowledge of medical terminology and insurance policies.

Requirements

High school diploma or equivalent (required)
Prior experience in medical billing, insurance authorization, or a similar role is strongly preferred.
Strong communication and customer service skills are essential.
Detail-oriented with basic computer skills, including experience with electronic medical records software and electronic health records (EHR).
Knowledge of medical terminology is beneficial.
Must be able to manage a high volume of work and meet deadlines.

Nice To Haves

associate degree or higher a plus

Responsibilities

Verify insurance and benefits: Confirm patient eligibility and benefits for scheduled procedures with various insurance carriers (e.g., Medicare, Medicaid, commercial).
Obtain pre-authorization: Secure the required prior approval from insurance companies for medical services, prescriptions, or treatments.
Gather information: Collect necessary medical documentation from referring physicians and clinical staff to support the authorization request.
Communicate with stakeholders: Act as a liaison between patients, physicians, insurance representatives, and facility staff.
Document and manage records: Accurately enter all information into the practice management system and maintain records of authorizations, denials, and appeals.
Address issues: Follow up on pending authorizations, resolve problems, and handle any issues that arise during the process.
Inform patients: Explain insurance coverage, authorization status, and any financial responsibilities to the patient.

Benefits

401(k) company contribution of 7.5% annual salary (whether you contribute or not)
Dental insurance
Health insurance
Vision
Company Paid Life insurance
20k Company Paid AD&D
20K Company Paid Long-Term Disability 60%
6 Days of Sick Time
8 Paid Holidays
10 Days of Vacation Time
Milestone Checks
Cabin/Condo for vacations