Precertification Specialist

CONSULTANTS IN GASTROENTEROLOGY PA • WEST COLUMBIA, SC

35d • Onsite

About The Position

The Precertification Specialist ensures that procedures and scheduled tests are preauthorized with insurance companies. The role communicates with patients, insurance companies, physicians, co-workers, and area medical centers; documents communications in the computer; and refers complex issues to the business office team lead. The position requires accuracy, attention to detail, timeliness, organization, dependability, and the ability to work with little supervision. The specialist must respect patient privacy, dignity, and confidentiality and abide by OSHA and HIPAA regulations.

Requirements

• High school diploma or GED certificate.
• Good communication skills.
• Good computer skills.
• Cooperative work attitude toward co-employees, management, patients, visitors, and physicians.
• Ability to make logical decisions and solve problems.
• Knowledge of CPT and ICD-10 coding applications.
• Strong ethical and moral character references.
• Pass background, drug, and security checks.
• Accuracy, attention to detail, timeliness, and organization.
• Ability to work with little supervision, follow instructions, meet deadlines, and maintain attendance and punctuality.
• Ability to sit, stand, and walk.
• Visual and auditory acuity for frequent use of a computer and telephone and occasional use of other office equipment.

Nice To Haves

• GI knowledge.

Responsibilities

• Work the daily schedule to ensure all procedures and scheduled tests are preauthorized with insurance companies.
• Document all communication in the computer.
• Receive calls from patients or insurance companies related to patient authorization or precertification.
• Work with area medical centers to ensure appropriate authorizations are completed.
• Forward complex problems or questions to the business office team lead.
• Communicate effectively and professionally with patients, visitors, physicians, and co-workers.
• Interact with others in a positive, respectful, and considerate manner and act as a positive role model and team member.
• Respect patients’ rights to privacy, dignity, and confidentiality.
• Abide by OSHA and HIPAA regulations.

What This Job Offers

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