Pre-Certification Specialist (32056)

GI Alliance; Austin (TX); On-site; USD 38,000 - 54,000; Full time

Job summary

GI Alliance is seeking a Precertification Specialist responsible for coordinating with insurance companies to obtain proper certification/authorization before patient appointments and procedures.

The ideal candidate will have at least two years of precertification experience, a high school diploma or GED, and strong knowledge of medical terminology, ICD-10 and CPT-4 codes, with excellent written and verbal communication and solid data-entry skills.

Qualifications

• High school diploma or GED required.
• Minimum of two years precertification experience.
• Proficient knowledge of medical terminology, ICD-10 and CPT-4 codes.

Responsibilities

• 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.

Skills

Excellent communication

Data entry

Multitasking

Initiative

Ethics

Education

High School diploma or GED

Job description

Position Purpose

Responsible 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

• 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.

Education

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.