Insurance Precertification Specialist

CCMC Cook Children's Medical Center; United States; On-site; USD 42,000 - 64,000; Full time

Job summary

Cook Children's Medical Center is seeking an Insurance Precertification Specialist to verify insurance coverage, obtain referrals, and manage prior authorizations and claims processing. In this role you will schedule procedures, radiology, and ancillary services, verify coverage, and handle referrals and authorizations for timely service.

Daily responsibilities include communicating with patients about scheduling and insurance requirements, maintaining accurate documentation, and coordinating

Qualifications

• High School Diploma.
• 2 years billing and insurance experience.
• 2 years front office practice operations experience.
• Understanding of general accounting principles.

Responsibilities

• Obtain insurance verification, referral authorization, processing and follow up of insurance claims and collections.
• Schedule procedures, radiology, and ancillary services; verify insurance coverage and benefits; obtain referrals and prior authorizations; and process and follow up on insurance claims.
• Communicate with patients regarding scheduling, insurance requirements, and procedure preparation; maintain accurate and timely documentation; coordinate with providers, clinical staff, insurance companies, and outside facilities to ensure continuity of care.
• Adhere to all front office procedures and policies.

Skills

Billing & Insurance Knowledge

Front Office Operations

Patient Scheduling

Education

High School Diploma

Job description

Location

Location: Dodson Medical Office Building Department: Cln-Gastro (GI) Shift: First Shift (United States of America) Standard Weekly Hours: 40

Summary

The Insurance Precertification Specialist will obtain insurance verification, referral authorization, processing and follow up of insurance claims and collections as required. Responsibilities include scheduling procedures, radiology, and ancillary services; verifying insurance coverage and benefits; obtaining referrals and prior authorizations; and processing and following up on insurance claims.

Additional Responsibilities

Additional responsibilities include communicating with patients regarding scheduling, insurance requirements, and procedure preparation; maintaining accurate and timely documentation; and coordinating with providers, clinical staff, insurance companies, and outside facilities to ensure continuity of care and timely completion of services.

Expectations

Expected to have knowledge of all front office procedures and adhere to all policies and procedures.

Education & Experience

Education & Experience: High School Diploma. 2 Years Billing and Insurance Experience. 2 Years Front Office Practice Operations Experience. Understanding of General Accounting Principles.

Hours

Hours: Monday to Friday: 8:00am to 5:00pm

About Us

Cook Children's is an equal opportunity employer. As such, Cook Children's offers equal employment opportunities without regard to race, color, religion, sex, age, national origin, physical or mental disability, pregnancy, protected veteran status, genetic information, or any other protected class in accordance with applicable federal laws. These opportunities include terms, conditions and privileges of employment, including but not limited to hiring, job placement, training, compensation, discipline, advancement and termination.

Cook Children's is a Texas-only employer. If you are hired, you will need to maintain your primary residence within the state of Texas, along with all licenses and credentials required for your position throughout your employment.

Promise

Promise, a strong word with deep meaning that everyone understands - especially kids. This is the foundation of our organization and what drives us to blaze new trails in medical care, research, advanced technology, as well as programs and initiatives that benefit children who may not otherwise have access to quality health care.

Every day our employees come to work with the intention of keeping our Promise. It's the guiding principle that helps our patients and their families get better and stay healthy. As a member of our Cook Children's team, you can be an important part of making that happen.