Patient Access & Precertification Specialist

Borland Groover; Jacksonville (FL); On-site; USD 25,000 - 36,000; Full time

Benefits offered by this job

Health Insurance

Vision Insurance

401K Retirement Plan

Life Insurance

Disability Insurance

Profit Sharing

Tuition Reimbursement

EAP

PTO

Paid Holidays

Job summary

Borland Groover, Florida's leading gastroenterology provider, seeks a Precertification Specialist to ensure referrals and authorizations so clinics and ambulatory surgical centers are reimbursed for services rendered.

Responsibilities include verifying eligibility, obtaining referrals and precertifications, handling patient calls, scheduling, payment arrangements, and coordinating with insurers. HIPAA training is required; adherence to the Code of Conduct and Compliance initiatives is expected.

Qualifications

• Ability to communicate effectively with patients, physicians and staff.
• HIPAA training is required and compliance must be followed.
• Experience with insurance processes or precertification is a plus.

Responsibilities

• Verify benefits and/or eligibility of patients that are scheduled to be seen.
• Obtain a referral as needed before a patient is seen by a physician.
• Obtain precertifications before tests and procedure(s) are performed.
• Take incoming calls from patients to help them understand insurance requirements or to schedule/reschedule appointments.
• Conduct outbound calls to patients as necessary.
• Complete payment arrangements for patients when necessary.
• Contact insurance companies to inquire about benefits or authorizations requirements.
• Assist satellite office personnel with insurance or precertification comprehension.

Skills

Communication

Critical Thinking

Compassion

Time Management

Education

High School Diploma or equivalent

Job description

Borland Groover, Florida's leading gastroenterology provider, seeks a Precertification Specialist to ensure referrals and authorizations so clinics and ambulatory surgical centers are reimbursed for services rendered.

Responsibilities include verifying eligibility, obtaining referrals and precertifications, handling patient calls, scheduling, payment arrangements, and coordinating with insurers. HIPAA training is required; adherence to the Code of Conduct and Compliance initiatives is expected.