AR Precertification Specialist TOC HSV

Overview

The Orthopaedic Center is looking for a highly motivated AR Precertification Specialist. This opening is a full-time position averaging 40 hours per week. The AR Precertification Specialist will pre-certify all patients for office visits, consultations, testing, and procedures as required by each patient's insurance company by monitoring patient schedules in the billing system for each department. Follow insurance company pre-certification requirements for approval, such as calling, faxing, emailing, logging into their system online, etc. Assist accounts receivable, coding, registration, and insurance follow up staff on an as-needed basis. Answer requests from various departments regarding pre-cert requirements for various insurance companies. Reviews pre-cert requirements for insurance companies in a timely manner to maintain up-to-date knowledge of requirements. Notifies appropriate staff on status of approval/denials. Forwards denials to manager and appropriate staff for further review and decision making. Maintains strict confidentiality. Performs other duties as assigned.

Qualifications

Education required: HS/GED

Experience: Coding, AR, Insurance reimbursement knowledge required. Three years insurance and/or billing experience preferred. One year of healthcare experience preferred.

Additional Skills/Abilities:

• Ability to work under pressure
• Outstanding organizational and writing skills
• Ability to speak clearly and concisely
• Independent, self-starting and highly motivated
• Proven positive, "teamwork" attitude in work history