Medical Office Assistant Jobs

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Precertification Specialist - Longstreet Clinic - OBGYN

Northeast Georgia Health SystemGainesville, GA
Onsite

About The Position

The Precertification Specialist is responsible for obtaining pre-certification and referrals from all insurance plans for services provided to NGHC patients, ensuring proper reimbursement. This role involves verifying insurance benefits and eligibility, and identifying managed care contracts and referral patterns.

Requirements

  • High School Diploma or GED.
  • Demonstrates tact to deal effectively with patients, physicians and other employees of the practice
  • Excellent verbal communication skills
  • Initiative and drive to take a project from its inception to a successful conclusion
  • Ability to maintain strict confidentiality regarding patient information

Nice To Haves

  • Medical Office Assistant certificate.
  • Minimum of one (1) year in medical office or hospital setting with experience in pre-certification or referral.

Responsibilities

  • Responsible for obtaining pre-certification/referrals from all insurance plans for services provided to THC patients as it relates to reimbursement.
  • Verify insurance benefits and eligibility.
  • Identify managed care contracts and referral patterns.
  • Assist in processing insurance claims.
  • Answer patient questions and inquiries regarding their accounts.
  • Verify insurance eligibility and coverage guidelines as well as process benefit correspondence in system.
  • Assist patients in completing necessary forms to obtain pre-certification from insurance companies.
  • Maintain pre-certs for in office procedures and out of office procedures such as MRI, MRA, CT, PET and caths.
  • Follow up with insurance companies ensuring that pre-certification is approved.
  • Follow up with other doctors offices to ensure that referral has been obtained for office visits.
  • Assist with maintaining Health Access Referrals (2 per month), assist with maintaining District 2 referrals, assist with maintaining Well Care.
  • Assist in maintaining Medicaid REF and PROVIDER ID Tables as well as Referring Doctor Tables.
  • Other duties as assigned.
  • Add new insurance carriers into system as needed.
  • Performs other related job duties or functions as requested or assigned.

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What This Job Offers

Job Type

Full-time

Career Level

Entry Level

Education Level

High school or GED

Number of Employees

501-1,000 employees

Career Resources

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