The Pre-certification Representative is responsible for obtaining approval from insurance companies for services that require referral, pre-certification or prior authorization. All job functions are performed in a manner that promotes the highest level of compliance with various legal, regulatory and accreditation requirements while maintaining all protected health information in manner that complies with HIPAA requirements.
Qualifications:Education: High school diploma or GED required. Post-secondary education preferred.
Experience: Three years of medical insurance or medical billing experience required. Two – three years of prior experience with pre-certifications preferred.
Additional Skills/Abilities: Proficiency working with computer applications, including Microsoft Office and EMR/Billing systems is required. Understanding of medical terminology is required. Broad understanding of insurance company requirements related to services that require referral, pre-certification or prior authorization required. Effective work habits including, regular and prompt attendance, dependability, teamwork and initiative is required. Excellent verbal and written skills are required. Ability to type 35 wpm with 90% accuracy is required. Ability to process a high volume of work in an accurate manner. Ability to communicate effectively both verbally and in writing. Must possess ability to work in a fast-paced environment with a positive attitude. Must demonstrate effective time management skills. Must demonstrate efficiency and organizational skills with the ability to multitask. Ability to compile and analyze data preferred. Should possess a drive to be team oriented. Should possess strong ethics with a clear understanding of right and wrong which guides actions. Should possess self-discipline to actively impose structure onto Registration personnel. Should possess the disposition of responsibility, assuming personal accountability for work and actions. Should be a problem solver, able to think things through with incomplete data. Should possess empathy, able to relate to the feelings and perspectives of others. Should possess individualized perception, being aware and attentive to individual differences. Should be persuasive, able to persuade others in a logical manner. Should possess ability to take charge and lead.
Highlights of our hospitals
Huntsville Hospital was recently named Best Regional Hospital and #2 in Alabama by U.S. News & World Report. With 971 beds, a specialized Orthopedic & Spine Tower, a Level III Regional Neonatal ICU, and the largest Emergency Department and Level 1 Trauma Center in the state with our own specialized Red Shirt Trauma Program, there are many opportunities to apply your knowledge and skills. We are a certified Primary Stroke Center and named "One of the Top 100 Hospitals in the Nation with Great Heart Programs." From six cath labs and four EP labs to multiple medical and step-down units, you can continually grow your skillset! We offer a training center on campus for continuing education, Shared Governance Program, Clinical Ladder for professional development, The Daisy Award, and if you are a new grad, a Nurse Residency Program to help you transition from student to professional nurse. We care about you and your well-being by offering an excellent benefits package, childcare, health and wellness programs, an onsite employee pharmacy, a free health clinic, tuition assistance, and much more. We are committed to creating a diverse environment and proud to be an equal opportunity employer. We are a partner to the U.S. Army’s Partnership for Your Success (PaYS) program.
Ask us about incentives and additional opportunities.
Huntsville Hospital Benefits:
We are committed to providing competitive benefits. Our benefits package for eligible employees includes medical, dental, vision, life insurance, flexible spending; short term and long term disability; several retirement account options with 401K organization match; nurse residency program; tuition assistance; student loan reimbursement; On-site training and education opportunities; Employee Discounts to phone providers, local restaurants, tickets to shows, apartment application and much more!
Learn more about Huntsville Hospital Health System: