Pre-Cert Verification Coordinator

Oklahoma Heart Hospital; Oklahoma City (OK); On-site; USD 38,000 - 48,000; Full time

Benefits offered by this job

Medical, Dental, Vision coverage

401(k) with employer match

PTO - Paid Time Off

Employee Assistance Programs (EAP)

Job summary

Oklahoma Heart Hospital in Oklahoma City is seeking a Pre-Certification Verification Coordinator to join our fast-paced team. You will be responsible for pre-registration, pre-authorization, insurance verification, and arranging payment with patients prior to tests or procedures.

Work closely with physicians, nurses and insurance companies to resolve authorization issues and verify coverage while maintaining HIPAA standards and excellent patient service.

Qualifications

• High school diploma; some college preferred.
• Minimum 50 wpm; at least one year of job-related experience or current healthcare work.
• Knowledge of Medicare/Medicaid and commercial insurance reimbursement.
• Excellent customer service with strong written and verbal communication; good investigative and telephone skills.
• Handle patient information; adhere to HIPAA requirements.

Responsibilities

• Pre-register patients, obtain pre-authorization and verify insurance prior to testing or procedures.
• Calculate patient portion and arrange payment prior to admission.
• Communicate potential pre-authorization issues to physicians and teams.
• Handle patient confidential information and liaise with payers and insurance companies.

Education

High school diploma; some college preferred

Job description

Overview

Join Our Team at Oklahoma Heart Hospital (OHH)

ONE TEAM. ALL HEART. At OHH, we believe that patient care is truly at the heart of everything we do. Our dedicated team members are involved in every step of our patients' journeys, bringing hope, compassion, and healing to both patients and their families. Together with our physicians and caregivers, we're shaping the future of heart care in Oklahoma by serving the state and leading the nation.

Why You'll Love Working Here:

• Comprehensive Benefits:
  • Medical, Dental, and Vision coverage
  • 401(k) plan with employer match
  • Long-term and short-term disability
  • Employee Assistance Programs (EAP)
  • Paid Time Off (PTO)
  • Extended Medical Benefits (EMB)
  • Opportunities for continuing education and professional growth

Please note that benefits may vary by position, and some roles (like PRN, Flex, Float, etc.) may have exclusions. For eligible positions, benefits start on your first day!

We can't wait for you to join our heart-centered team!

Responsibilities

The OHH Pre-Cert Veification Coordinator will work in a fast-paced environment this position is responsible for pre-registration of patients, to include pre-authorization, insurance verification, calculation of patient portion prior to a patient's testing or procedure and arrangements with patient for payment at time of service prior to admission to OHH and/or its clinics. Notifies Registration of any patient financial obligation for collection prior to service. Team member is responsible for communicating any potential issues surrounding pre-authorization or other pre-arrival requirements to physicians and their teams as well as others involved in the patient's care. Requires extensive contact with the insurance companies/payers, public and employees. Handles patient confidential information.

Essential Functions

• Obtains list of patients admitted and scheduled daily and reviews each patient account to determine action needed.
• Team member will work with their unit to obtain pre-auth for 100+ physicians. The team member is in direct contact with physicians, nurses and patients as well as insurance companies and their clerical or clinical staff.
• Obtains required insurance verification of scheduled services according to departmental guidelines a minimum of one day prior to admission or registration of services; within 24 hours of ER services.
• Obtains required insurance verification of weekend admissions according to departmental guidelines within 24 hours of notification of admission.
• Follows through on delivery of requested items to insurance company.
• Accepts and places calls to patients and employer groups as needed and updates information as needed.
• Notifies director of any consistent errors or issues.
• Adheres to all hospital policies and procedures.

Knowledge of anatomy, physiology or medical terminology will be helpful in this position. Proven organization and time management skills are crucial. Creativity and innovation is highly encouraged. Successful applicants are passionate about helping others, are teachable, learn quickly, will exceed expectations, are solution-oriented and looking for future leadership opportunities. They handle patient confidential information and will adhere to all HIPAA expectations.

Qualifications

Education: High school diploma; prefer some college

Experience: Minimum of 50 wpm. Candidate should have at least one (1) year of job related experience or currently work in the Health Care field. Knowledge of third party reimbursement, including Medicare, Medicaid and commercial insurance required. Excellent Customer Service background. Good investigative skills and telephone techniques. Must have solid written and verbal communication skills.

As part of our team, you are empowered to work collaboratively with our physicians and other caregivers, and play an integral role in setting the standard for excellence in patient care. Every team member at OHH plays an integral role in our patients' experience. They are the reason OHH continues to serve the state and lead the nation. Be part of the future of cardiac care.

Responsibilities

The OHH Pre-Cert Veification Coordinator will work in a fast-paced environment this position is responsible for pre-registration of patients, to include pre-authorization, insurance verification, calculation of patient portion prior to a patient's testing or procedure and arrangements with patient for payment at time of service prior to admission to OHH and/or its clinics. Notifies Registration of any patient financial obligation for collection prior to service. Team member is responsible for communicating any potential issues surrounding pre-authorization or other pre-arrival requirements to physicians and their teams as well as others involved in the patient's care. Requires extensive contact with the insurance companies/payers, public and employees. Handles patient confidential information.

Essential Functions

• Obtains list of patients admitted and scheduled daily and reviews each patient account to determine action needed.
• Team member will work with their unit to obtain pre-auth for 100+ physicians. The team member is in direct contact with physicians, nurses and patients as well as insurance companies and their clerical or clinical staff.
• Obtains required insurance verification of scheduled services according to departmental guidelines a minimum of one day prior to admission or registration of services; within 24 hours of ER services.
• Obtains required insurance verification of weekend admissions according to departmental guidelines within 24 hours of notification of admission.
• Follows through on delivery of requested items to insurance company.
• Accepts and places calls to patients and employer groups as needed and updates information as needed.
• Notifies director of any consistent errors or issues.
• Adheres to all hospital policies and procedures.

Knowledge of anatomy, physiology or medical terminology will be helpful in this position. Proven organization and time management skills are crucial. Creativity and innovation is highly encouraged. Successful applicants are passionate about helping others, are teachable, learn quickly, will exceed expectations, are solution-oriented and looking for future leadership opportunities. They handle patient confidential information and will adhere to all HIPAA expectations.

Education

High school diploma; prefer some college

Experience

Minimum of 50 wpm. Candidate should have at least one (1) year of job related experience or currently work in the Health Care field. Knowledge of third party reimbursement, including Medicare, Medicaid and commercial insurance required. Excellent Customer Service background. Good investigative skills and telephone techniques. Must have solid written and verbal communication skills.

As part of our team, you are empowered to work collaboratively with our physicians and other caregivers, and play an integral role in setting the standard for excellence in patient care. Every team member at OHH plays an integral role in our patients' experience. They are the reason OHH continues to serve the state and lead the nation. Be part of the future of cardiac care.