Prior Authorization/Pre-Certification Coordinator
About The Position
The Prior Authorization/Pre-Certification Coordinator is responsible for performing prior authorizations, pre-certifications for surgeries, pre-collecting funds as appropriate, and other office procedures as necessary. JOB DESCRIPTION: Responsible for performing prior authorizations and pre-certifications for surgeries, other office procedures as necessary, and pre-collecting funds as appropriate. Assist patients in obtaining prior authorizations and pre-certifications. Serves as a resource for staff and physicians regarding prior authorization and pre-certification policies and procedures. Attends various meetings and enhances professional development and growth on a regular basis; makes recommendations for revision and/or new departmental procedures under the direction of the supervisor. Incorporates the use of technology. Completes pre-certification and prior authorizations online as required. Remains up to date on the areas of coding and new codes. Maintains insurance knowledge. Communicate effectively and compassionately with patients. Communicate effectively with staff, management, and physicians.
Requirements
- High school diploma or equivalent
- Coding coursework and knowledge required
- Good computer skills required
- Minimum of one-year customer service or reception experience, preferably in a medical office environment
- Two years of experience working with various insurances
- Prior experience in Prior Authorization/Pre-certification preferred
Nice To Haves
- Knowledge of Athena Medical Practice Management System preferred, but not required
- Knowledge of Microsoft Office Suite helpful, but not required
Responsibilities
- Performing prior authorizations
- Pre-certifications for surgeries
- Pre-collecting funds as appropriate
- Assist patients in obtaining prior authorizations and pre-certifications
- Serves as a resource for staff and physicians regarding prior authorization and pre-certification policies and procedures
- Attends various meetings and enhances professional development and growth on a regular basis
- Makes recommendations for revision and/or new departmental procedures under the direction of the supervisor
- Incorporates the use of technology
- Completes pre-certification and prior authorizations online as required
- Remains up to date on the areas of coding and new codes
- Maintains insurance knowledge
- Communicate effectively and compassionately with patients
- Communicate effectively with staff, management, and physicians
- Efficient and accurate prior authorizations and pre-certifications of patients
- Maintain patient confidentiality
- Attendance and punctuality
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
