Pre-Certification Specialist — Streamline Patient Approvals

Clearway Pain Solutions; Montgomery (AL); On-site; USD 36,000 - 54,000; Full time

Benefits offered by this job

Health Insurance

Competitive wage

Fantastic team

Efficient work environment

Job summary

The Center for Pain in Montgomery, AL seeks a meticulous Pre-Certification Specialist to verify insurance, initiate pre-authorizations, and document approvals and denials. You will collaborate with physicians, billing, and staff to gather information and ensure timely processing.

The role emphasizes accuracy, confidentiality, and adherence to HIPAA. A supportive environment, health insurance benefits, and professional growth are highlighted as part of a strong team.

Qualifications

• Strong verbal and written communication skills and professional interaction with patients, insurers, and staff.
• Proficient computer skills and comfortable using healthcare management software.
• Exceptional organizational and multitasking abilities to handle high volume of requests efficiently.
• Familiarity with insurance policies, pre-authorization procedures, and medical terminology.
• Commitment to maintaining patient confidentiality and HIPAA compliance.

Responsibilities

• Verify patient insurance to determine pre-authorization requirements.
• Initiate and manage the pre-certification process for procedures and medications.
• Maintain accurate records of pre-authorization approvals and denials and communicate with providers, patients, and insurers.
• Collaborate with healthcare providers, billing, and administrative staff to gather necessary information.
• Monitor status of pre-certification requests, address issues or denials, and appeal as necessary to ensure timely approval.
• Stay informed about changes in insurance regulations and policies to ensure compliance.

Skills

Communication

Computer skills

Detail oriented

Insurance knowledge

HIPAA compliance

Tools

Healthcare software

Job description

The Center for Pain in Montgomery, AL seeks a meticulous Pre-Certification Specialist to verify insurance, initiate pre-authorizations, and document approvals and denials. You will collaborate with physicians, billing, and staff to gather information and ensure timely processing.

The role emphasizes accuracy, confidentiality, and adherence to HIPAA. A supportive environment, health insurance benefits, and professional growth are highlighted as part of a strong team.