Precertification Specialist

Borland Groover•Jacksonville, FL

7d•Onsite

About The Position

The Precertification Specialist at Borland Groover is a part of the Patient Access department. The general duty of this position is to ensure each patient has a referral and/or authorization so that the clinic and ambulatory surgical centers will be reimbursed for all services rendered.

Requirements

High School diploma required.
Previous experience is required.
Ability to communicate effectively with patients, physicians and staff both verbally and in writing.
Works well with patients, physicians, and staff.
Attention to detail.
Ability to handle multiple tasks in a possibly stressful environment.
Ability to handle patient issues in a tact, professional way.

Nice To Haves

Previous experience preferred but not .

Responsibilities

Verify benefits and/or eligibility of patients that are scheduled to be seen.
Obtain a referral as needed before a patient is seen by a physician.
Obtain precertifications before tests and procedure(s) are performed.
Take incoming calls from patients to help them better understand their insurance and requirements and/or to schedule or reschedule patient appointments as needed.
Conduct outbound calls to patients as necessary.
Complete payment arrangements for patients when necessary.
Contact insurance companies to inquire about benefits or authorizations requirements.
Assist the satellite office personnel with insurance or precertification comprehension as needed.
Answer nurse or patient portal inquiries assigned to the department.
This job requires access to Personal Health Information (PHI), HIPAA training is required, and HIPAA compliance is expected.
Must follow the organization’s Code of Conduct.
Must participate in the Compliance Program Initiatives and reporting and Compliance Issues.
Handle all other duties as assigned.