Precertification Specialist Ohio Valley Pain Institute Louisville, KY Job Details Full-time $20 - $22 an hour 23 hours ago Benefits Health insurance Dental insurance 401(k) Paid time off Qualifications Customer communication Customer service Medical office experience HIPAA Health information management Medical terminology Full Job Description Overview Join our dynamic healthcare team as a Precertification Specialist, where you will play a vital role in ensuring smooth and efficient authorization processes for medical procedures and services. Your expertise will help facilitate timely approvals, support clinical teams, and uphold the highest standards of confidentiality and compliance. This energetic position offers an exciting opportunity to make a meaningful impact on patient care and operational efficiency through meticulous review and coordination of insurance authorizations. Duties Review medical documentation, including clinical records and physician notes, to determine the necessity of procedures in accordance with health insurance policies and clinical guidelines. Verify insurance coverage, manage prior authorization requests, and communicate with managed care organizations to secure approvals for services. Utilize medical coding knowledge, including CPT (Current Procedural Terminology), ICD-9, ICD-10, and ICD coding systems, to accurately document procedures and diagnoses. Maintain detailed records of authorization requests, correspondence, and outcomes within electronic health records (EHR) systems while ensuring compliance with HIPAA regulations. Collaborate closely with healthcare providers, insurance representatives, and patients to gather necessary documentation and clarify authorization requirements. Stay updated on changes in health insurance policies, medical billing procedures, and clinical confidentiality policies to ensure compliance and efficiency. Provide exceptional customer service by addressing inquiries professionally and supporting patients through the authorization process. Experience Previous experience in a medical office environment or healthcare setting involving insurance verification, prior authorization, or medical records management. Strong understanding of health insurance policies, managed care processes, and medical billing practices. Proficiency in medical terminology, CPT coding, ICD coding (ICD-9/ICD-10), and electronic health record (EHR) management systems. Familiarity with HIPAA regulations to safeguard patient confidentiality at all times. Excellent organizational skills with the ability to handle multiple cases efficiently while maintaining attention to detail. Competence in Microsoft Office applications for documentation and communication purposes. Demonstrated customer service skills with a positive attitude toward supporting patients and healthcare providers. Embark on a rewarding career where your dedication ensures seamless healthcare delivery! We are committed to fostering an inclusive environment that values your expertise while offering opportunities for growth within the healthcare industry.

Pay:

$20.00 - $22.00 per hour

Benefits:

401(k) Dental insurance Health insurance Paid time off

Work Location:

In person