Pre-Certification Specialist (32832)

GI Alliance; Beaumont (TX); On-site; USD 38,000 - 52,000; Full time

Job summary

GI Alliance in Beaumont, TX seeks an Insurance Authorization Specialist to manage precertification and prior authorization with insurance companies for scheduled appointments and tests.

You will document financial responsibilities, verify waivers, and help our scheduling team with efficient data entry in the practice management system.

Qualifications

• Education: High School diploma or GED.
• Minimum of two (2) years of pre-certification experience required.
• Proficient knowledge of medical terminology, ICD-10 and CPT-4 codes.
• Excellent communication skills, both written and verbal.
• Proficient computer skills and ability to work in a practice management system.

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.
• Communicate patient financial information with office and billing personnel in a timely and accurate manner.
• Document within the practice management system all required information including 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

Communication skills

Medical terminology

Multi-tasking

Time management

Education

High School diploma or GED

Tools

Practice management software

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.

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

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.

Qualifications

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.