Pre-Certification Specialist

Paycom; Austin (TX); On-site; USD 42,000 - 54,000; Full time

Job summary

Paycom is seeking an experienced specialist to coordinate precertifications and authorizations with insurance companies for patient appointments and tests in the Austin, TX area.

The role requires strong communication, attention to detail, and ability to work with a practice management system, ICD-10/CPT-4 codes, and waivers. A high school diploma or GED is required, with 2+ years of precertification experience preferred.

Qualifications

• Excellent written and verbal communication skills.
• Proficient computer skills and ability to learn practice software.
• Ability to multi-task and prioritize in a healthcare setting.
• Self-motivated with initiative and strong ethics.

Responsibilities

• Obtain precertification and prior authorization for appointments, tests and procedures.
• Contact insurance companies to obtain precertification and record data in the system.
• Communicate patient financial information with billing staff promptly and accurately.
• Verify waivers for tests/procedures prior to the date of service.
• Perform light data entry and other related office duties.

Skills

Excellent communication

Proficient computer skills

Multi-tasking

Initiative

Ethics

Education

High School diploma or GED

Tools

Practice management system

Medical terminology

ICD-10/CPT-4 knowledge

Job description

Position purposeResponsible for the communicating with insurance companies to ensure proper certification/authorization is obtained prior to patient’s appointment and all scheduled tests and procedures.Responsibilities/Duties/Functions/Tasks:Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Obtain all requests for precertification and prior authorization from insurance companies for appointments, scheduled tests and procedures.Contact insurance companies as needed to obtain precertification and record on form data entry.Communicates necessary patient financial information with appropriate office and billing personnel in an efficient, timely and accurate manner.Documents, within the practice management system, all required information to include financial responsibility.Verify waivers have been signed as needed for tests and procedures prior to date of service.Communicate with staff on any adjustments on precertification.Light data entry and other related office duties.Other duties as assigned.QualificationsEducation: High School diploma or GED.Experience: Minimum of two (2) years of pre-certification experience required.Requirements for Level I Status:Entry level (1-4 years’ experience) and/or meet the basic requirements of the job with the need for additional supervision.Excess of 4 years’ experience if meeting only the basic requirements of the job with need for additional supervision.Additional Qualifications: Proficient knowledge of medical terminology, ICD-10 and CPT-4 codes.Performance Requirements:Excellent communication skills, both written and verbal.Proficient technical (computer) skills.Ability to multi-task and prioritize.Self-motivated with initiative.Strong sense of ethics.