Oncology Pre-Certification & Scheduling Specialist

Charleston Area Medical Center; Charleston (WV); On-site; USD 42,000 - 54,000; Full time

Job summary

Charleston Area Medical Center Cancer Center is seeking a Pre-Certification Specialist to secure accurate pre-certification/authorization for returning and new patients and to complete patient charts. This role involves coordinating scheduling of physician-ordered tests, exams and surgeries where applicable.

Responsibilities include daily chart reviews for pre-certification needs, verifying insurance data for medical necessity, contacting insurers for data, and scheduling procedures with proper

Qualifications

• Review patient charts to determine pre-certification or referrals needed.
• Verify insurance data to determine medical necessity.
• Communicate with insurers to obtain authorizations and verifications.

Responsibilities

• Daily review of charts to determine pre-certification or referrals needed.
• Review patient insurance info to determine medical necessity requirements.
• Correspond with Medicare and various insurance companies to obtain data on compliance and precertification requirements.
• Schedule patient surgery and communicate all necessary information to involved parties.
• Establish new patient accounts in billing software and forward information for charting.
• Cross-train for front desk and medical assistant roles and provide back-up as needed.
• Maintain knowledge of ICD-10, CPT and HCPCS codes.

Education

High School Diploma or GED

Job description

Charleston Area Medical Center Cancer Center is seeking a Pre-Certification Specialist to secure accurate pre-certification/authorization for returning and new patients and to complete patient charts. This role involves coordinating scheduling of physician-ordered tests, exams and surgeries where applicable.

Responsibilities include daily chart reviews for pre-certification needs, verifying insurance data for medical necessity, contacting insurers for data, and scheduling procedures with proper