Medical Pre-Certification & Insurance Verification Specialist

CharterCARE of Rhode Island; Providence (RI); On-site; USD 42,000 - 52,000; Full time

Job summary

CharterCARE Roger Williams Medical Center in Providence, RI seeks an Administrative Support Specialist to verify insurance coverage and obtain authorizations for treatments in the Cancer Center/Infusion Suites.

You will enter and track preauthorizations, verify patient benefits, and understand Medicare, Medicaid, and commercial payer guidelines. High school diploma required; associate degree preferred; 2–3 years of insurance verification experience.

Qualifications

• High School Diploma or GED required.
• Associate degree preferred.
• Knowledge of CPT, ICD-10 coding and J codes.
• Knowledge of insurance coverage and reimbursement practices.
• 2–3 years of insurance verification and preauthorization experience in healthcare.

Responsibilities

• Obtain all required authorizations prior to treatments in Cancer Center/Infusion Suites.
• Verify patient insurance coverage, benefits and out-of-pocket responsibilities.
• Enter and track all authorizations and pre-certs as required by payers.
• Understand Medicare, Medicaid and commercial payer guidelines.

Skills

Verbal communication

Written communication

Independent work

Teamwork

Organization

Detail oriented

Learning new software

Persistence in follow-up

Education

High School Diploma or GED

Associate degree preferred

CPT/ICD-10 knowledge

Insurance reimbursement knowledge

Tools

Microsoft Office

Job description

CharterCARE Roger Williams Medical Center in Providence, RI seeks an Administrative Support Specialist to verify insurance coverage and obtain authorizations for treatments in the Cancer Center/Infusion Suites.

You will enter and track preauthorizations, verify patient benefits, and understand Medicare, Medicaid, and commercial payer guidelines. High school diploma required; associate degree preferred; 2–3 years of insurance verification experience.