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Orthopedic Health of Kansas City

Precertification Representative

Entry-Level JobVerifiedNo experience needed

Career Insights for Medical Claims Processor / Representative

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Based on Missouri data

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What they do

A Medical Claims Processor or Representative reviews and processes medical insurance claims and determines whether an insurance policy will cover a medical procedure. Gathers information from policy holders and organizes insurance files; may process checks with payments to policy holders when a medical claim is approved.

$44,009 / year median in Missouri

-6% projected decline

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Job Description

Precertification Representative Orthopedic Health of Kansas City - 2.8 Kansas City, MO Job Details 12 hours ago Qualifications High school diploma or
GED Full Job Description Precertification Representative Location:
Kansas City, MO, 64116 Job Description We are seeking a detail-oriented and customer-focused Precertification Representative to join our team in Kansas City, MO. The ideal candidate will be responsible for obtaining prior authorizations and precertifications from insurance companies to ensure timely and accurate processing of medical services. Responsibilities Contact insurance companies to obtain precertifications and prior authorizations for medical procedures and services. Verify patient insurance coverage and eligibility. Communicate with healthcare providers, patients, and insurance representatives to gather necessary information. Maintain accurate records of all precertification requests and approvals. Follow up on pending authorizations to ensure timely completion. Assist in resolving any issues related to insurance denials or delays. Stay updated on insurance policies, procedures, and requirements. Qualifications High school diploma or equivalent; associate degree preferred. Previous experience in medical billing, insurance verification, or precertification is a plus. Strong communication and interpersonal skills. Ability to work independently and manage multiple tasks efficiently. Proficient in using computer systems and software related to healthcare administration. Detail-oriented with strong organizational skills. Work Environment This position is based in our Kansas City office and may require occasional interaction with healthcare providers and insurance representatives via phone and email.