Pre-Certification Specialist - Gainesville

Only for registered members Gainesville, United States

1 day ago

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$55,000 - $90,000 (USD) per year *
* This salary range is an estimation made by beBee
JOB TITLE: · Pre-Certification Specialist · Hour of Work: · Monday – Friday · Shift: · Day · Employment Type: · Non-Exempt · Direct Report: · Hospital Scheduling Manager · Director: · Director of Clinical Support · Key Responsibilities · Pre-certify insurance and obtain authoriza ...
Job description

JOB TITLE:
Pre-Certification Specialist

Hour of Work:
Monday – Friday


Shift:
Day


Employment Type:
Non-Exempt


Direct Report:
Hospital Scheduling Manager


Director:
Director of Clinical Support

Key Responsibilities

Pre-certify insurance and obtain authorizations for all office appointments (Office Visits, Testing, Nuclear, and PET)
Submit denied authorization requests for Clinical Review, Peer-to-Peer Review, or file appeals with the insurance company.
Verify patient insurance information prior to appointment date.
Scan all documentation regarding cardiac procedures, testing, and referrals.
All other duties as assigned.
The job holder must demonstrate current competencies applicable to the job position.

Qualifications/Requirements

High School graduate or GED
Minimum 1 year insurance experience in a health care organization or specialty practice, preferably Cardiology-based.
Proficiency in standard EHR and Practice Management software is required.
Proficiency in medical terminology with emphasis on Cardiology.
Working knowledge of insurance guidelines and terminology as well as CPT and ICD-10 coding.
Basic knowledge of electronic medical records retrieval system, computers, and the Internet.
Perform multiple tasks and meet deadlines.
Communicate effectively, efficiently, and professionally.
Knowledge of Intergy and Medical Manager systems highly preferred.


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