Pre-Cert Coordinator: Streamline Care & Compliance

Clearway Pain Solutions; Mitylene (AL); On-site; USD 42,000 - 60,000; Full time

Benefits offered by this job

Health Insurance Benefits

Job summary

The Center for Pain in Alabama is seeking a dedicated Pre-Certification Specialist to join our patient-centered team. You will verify insurance, initiate pre-certifications for procedures, and maintain precise documentation while collaborating with providers, billing, and administration.

This role offers a supportive work environment, HIPAA-compliant practices, and opportunities to learn from experienced physicians in a fast-paced clinic.

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.

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.

Skills

Insurance Verification

Pre-Certification Processing

Verbal & Written Communication

HIPAA Compliance

Data Entry & Attention to Detail

Tools

Healthcare Management Software

Job description

The Center for Pain in Alabama is seeking a dedicated Pre-Certification Specialist to join our patient-centered team. You will verify insurance, initiate pre-certifications for procedures, and maintain precise documentation while collaborating with providers, billing, and administration.

This role offers a supportive work environment, HIPAA-compliant practices, and opportunities to learn from experienced physicians in a fast-paced clinic.