Pre-Certification Specialist

Pre-Certification Specialist OrthoConnecticut - 2.6 Wilton, CT Job Details Full-time $21 - $23 an hour 9 days ago 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.