Pre-Certification Specialist - Full Time

York Hospital - York, ME (30+ days ago)3.6


York Hospital is a non-profit 501(c)(3) 79-bed hospital with five community sites and 13 physician practices. We use a loving-kindness approach to offer exceptional care in a healing environment. From primary and preventive care and diagnostic testing to specialized medicine and surgical specialties to rehabilitation and care at home, York Hospital is known for its passion for centering care around patients and families, and providing unbelievable experiences for all.

We have an opening for a an experienced Care Access Pre- Certification Specialist. This is a full time, 40hrs/wk position working in our Care Access Center at York Hospital. The hours for this position are M-F 8:00am-5:00pm.

The Care Access Pre-Certification Specialist is responsible for the following:

Verifying insurance coverage for all inpatient and observation bed admissions and initiate pre-certification with insurance companies; work in conjunction with Utilization Review nurses to coordinate process; provide documentation and revise admissions as necessary to insure proper claim submission
Register and verify coverage and obtain prior authorization for all surgery, special procedure and physical therapy patients
Assist York Hospital teams and medical practices with pre-certification questions and issues
In order to help us continue to provide exceptional Patient/Customer experiences we need you to have the following:

Minimum (2) or more years of Pre-Certification experience.
Excellent customer service and computer skills.
Hospital pre-certification experience is preferred.