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Pre-Certification Specialist

OrthoConnecticut -
Wilton, CT

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Job Details

Full-time
$21 - $23 an hour

Benefits

Profit sharing
Wellness program
Health savings account
AD&D insurance
Disability insurance
Dental insurance
Flexible spending account
Paid time off
Vision insurance
401(k) matching
Employee discount
Life insurance

Qualifications

Medical insurance coverage verification
Medical office experience
High school diploma or GED
Healthcare referral management
Pre-authorization review for utilization management
Patient interaction
Health insurance referral requirements

Full Job Description

GENERAL STATEMENT OF DUTIES:

Responsibilities include pre-certification/authorization of all diagnostic testing and in-office injections, as well as scheduling diagnostic testing

Schedule: Monday-Friday 8am-5pm

Benefits:

401(k) matching + profit sharing
Health/Dental/Vision Insurance
FSA/HSA options
Life insurance/AD&D/STD/LTD
Paid time off
Employee Discount Program
Wellness Program

RESPONSIBILITIES / WORK REQUIREMENTS:

Pre-Certification:

Verifies insurance coverage to obtain precertification/authorization for all radiology tests, specialty injections, and other services as needed.
Maintains contact with testing facilities regarding scheduled tests/STAT orders
Faxes all pre-authorized services to facilities, and makes any changes, as needed.
Enters benefits and precertification/authorization into EMR system.
Follows up daily on all pending orders, obtaining office notes if needed for insurance companies

REQUIRED KNOWLEDGE

High school graduation or GED; post graduate degree preferred
At least one year of work experience in a medical office setting
Knowledge of medical office procedures and insurance verification and Pre-Certification
Ability to demonstrate a mature, dependable, and responsible approach when interacting with patients, physicians, co-workers, and additional outside sources
Proactive self-starter
Understands referral requirements of major third party payers
Ability to multi-task, prioritize and exceptional attention to detail
Excellent organizational, verbal and written communication skills

OrthoConnecticut, delivering exceptional care and real results has always been our mission, though we did things a little differently when we opened our doors in 1954. Today, we provide orthopedic care in a new state-of-the-art Musculoskeletal Center of Excellence, in which we provide the full spectrum of high-quality services under one roof. Now we can diagnose and treat the complete range of musculoskeletal issues for all ages in one easily accessible location with minimal wait time and a more efficient patient experience. One thing that hasn't changed since in 1954: our commitment to you

OrthoConnecticut is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

The above statement reflects the general duties considered necessary to describe the principal functions of the job as identified and shall not be considered as a detailed description of all the work requirements that may be inherent in the job.

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