Pre-Cert Coordinator

Clearway Pain Solutions; Montgomery (AL); On-site; USD 36,000 - 54,000; Full time

Benefits offered by this job

Health Insurance

Competitive wage

Fantastic team

Efficient work environment

Job summary

The Center for Pain in Montgomery, AL seeks a meticulous Pre-Certification Specialist to verify insurance, initiate pre-authorizations, and document approvals and denials. You will collaborate with physicians, billing, and staff to gather information and ensure timely processing.

The role emphasizes accuracy, confidentiality, and adherence to HIPAA. A supportive environment, health insurance benefits, and professional growth are highlighted as part of a strong team.

Qualifications

• Strong verbal and written communication skills and professional interaction with patients, insurers, and staff.
• Proficient computer skills and comfortable using healthcare management software.
• Exceptional organizational and multitasking abilities to handle high volume of requests efficiently.
• Familiarity with insurance policies, pre-authorization procedures, and medical terminology.
• Commitment to maintaining patient confidentiality and HIPAA compliance.

Responsibilities

• Verify patient insurance to determine pre-authorization requirements.
• Initiate and manage the pre-certification process for procedures and medications.
• Maintain accurate records of pre-authorization approvals and denials and communicate with providers, patients, and insurers.
• Collaborate with healthcare providers, billing, and administrative staff to gather necessary information.
• Monitor status of pre-certification requests, address issues or denials, and appeal as necessary to ensure timely approval.
• Stay informed about changes in insurance regulations and policies to ensure compliance.

Skills

Communication

Computer skills

Detail oriented

Insurance knowledge

HIPAA compliance

Tools

Healthcare software

Job description

Are you a skilled and compassionate Pre-Certification Specialist looking for a fulfilling center opportunity? Look no further! The Center for Pain is seeking a dedicated individual to join our dynamic team and contribute to providing exceptional care to our patients.

Position: Pre-Certification Specialist

About Us: At The Center for Pain, we take pride in delivering top-notch healthcare services in a friendly and efficient environment. Our dedicated team of professionals is committed to providing excellent care to our patients. With a strong focus on a healthy work-life balance, we offer a competitive wage and a supportive work environment.

What Sets Us Apart:

• Great Lifestyle: We understand the importance of a balanced lifestyle, and our clinic promotes a healthy and positive work environment.
• Competitive Wage: We offer a competitive package to recognize and reward your skills and dedication.
• Fantastic Team: Join a group of fellow employees who are not just colleagues but a supportive and collaborative team.
• Efficiency: Despite our busy schedule, we pride ourselves on being highly efficient, ensuring a streamlined and organized work environment.
• Exceptional Physicians: Work alongside experienced and compassionate physicians who are leaders in pain management, providing an excellent learning environment.
• Health Insurance Benefits: Comprehensive health insurance coverage for employees, ensuring peace of mind for you and your family.

Key Responsibilities:

• Insurance Verification: Conduct thorough verification of patient insurance coverage to determine pre-authorization requirements.
• Pre-Certification Processing: Initiate and manage the pre-certification process for medical procedures, treatments, and medications, ensuring compliance with insurance guidelines.
• Documentation: Maintain accurate and up-to-date records of pre-authorization approvals and denials, and communicate effectively with healthcare providers, patients, and insurance companies.
• Collaboration: Work closely with healthcare providers, billing, and administrative staff to gather necessary information for the pre-certification process.
• Follow-Up : Monitor the status of pre-certification requests, promptly address any issues or denials, and appeal as necessary to ensure timely approval.
• Compliance: Stay informed about changes in insurance regulations and policies, ensuring that pre-certification processes align with industry standards and compliance requirements.

Qualifications:

• Previous experience in a pre-certification specialist role is a plus.
• Strong verbal and written communication skills, with the ability to interact professionally with patients, insurance companies, and internal team members.
• Proficient computer skills, comfortable using healthcare management software and other relevant tools.
• Exceptional organizational and multitasking abilities to handle a high volume of pre-certification requests efficiently.
• Attention to detail and accuracy in data entry.
• Familiarity with insurance policies, pre-authorization procedures, and medical terminology.
• Commitment to maintaining patient confidentiality and adhering to HIPAA regulations.