Orthopedics Pre-Certification Specialist

ProMedica Central Physicians; Toledo (OH); On-site; USD 42,000 - 66,000; Full time

Job summary

ProMedica Wildwood Orthopaedic & Spine Hospital is seeking a Pre-Certification Specialist to perform prior authorizations and certifications for orthopaedic procedures with payers. You will apply knowledge of coding for surgeries and injections and stay current with medical criteria used by third-party payers.

The role requires an associate degree or 5 years of billing/insurance verification experience, familiarity with ICD10/CPT codes, and 5 years in a medical office.

Qualifications

• Associate degree or 5 years of Billing/Insurance Verification experience.
• Familiarity with ICD10 and CPT codes applicable to services rendered.
• 5 years of relatable or equivalent experience in medical office.

Skills

Billing/Insurance Verification

ICD10/CPT knowledge

Medical office experience

Education

Associate degree

Job description

ProMedica Wildwood Orthopaedic & Spine Hospital is seeking a Pre-Certification Specialist to perform prior authorizations and certifications for orthopaedic procedures with payers. You will apply knowledge of coding for surgeries and injections and stay current with medical criteria used by third-party payers.

The role requires an associate degree or 5 years of billing/insurance verification experience, familiarity with ICD10/CPT codes, and 5 years in a medical office.