Precertification Representative – Contract Role (6 months minimum)The Precertification Specialist is responsible for obtaining prior authorizations for all procedural orders by successfully completing the authorization process with all commercial and government payers. Responsibilities include: * Receive requests from Clinic sites for procedures - Verify accuracy of CPT and ICD-10 diagnoses in the procedure order * Verify insurance benefits and loading information into the computer system * Initiate requests for authorization to the BO RNs * Obtain authorizations via payer website, phone or fax and following up regularly on pending cases. * Contact patients to discuss insurance or authorization matters. * Other Business Office duties as assigned.KNOWLEDGE, SKILLS, AND ABILITIES: Knowledge of obtaining authorizations for procedures and its direct impact on the practice’s revenue cycle. Understanding of payer medical policy guidelines while utilizing guidelines to manage authorizations effectively. Proficient use of CPT and ICD-10 codes. Excellent computer skills including Excel, Word, and Internet use. Detail oriented with exceptional organizational skills. Plans and prioritizes assigned tasks to meet deadlines. Excellent customer service skills; communicates clearly and effectively. Ability to multitask and remain focused while managing a high-volume, time-sensitive workload. EDUCATION/EXPERIENCE REQUIRED >High School Diploma or GED required/ College Degree preferred. 2 years medical prior authorization experience Required– Oncology/hematology or Specialists MD office preferred. Essential Business during this Pandemic – Requires work onsite. Must lbe available to work immediately and be able to work daytime Mon-Fri.
Job Type: Temporary
Pay: $20.00 - $25.00 per hour
- Medical Prior Authorization: 2 years (Required)
- Monday to Friday
- Day shift