Pre-Certification Specialist — Streamline Patient Care

cwpnonproviders; Montgomery (AL); On-site; USD 42,000 - 64,000; Full time

Benefits offered by this job

Health Insurance Benefits

Competitive Wage

Great Lifestyle

Job summary

The Center for Pain is seeking a Pre-Certification Specialist to verify patient insurance, initiate pre-certification, and manage approvals and denials. You will communicate with providers, patients, and insurers and collaborate with billing and administrative teams to gather necessary information.

The ideal candidate has strong communication, organizational, and HIPAA-compliant data-management skills, with experience in healthcare software.

Qualifications

• Excellent verbal and written communication abilities for interactions with patients, insurers, and staff.
• Proficient computer skills and experience with healthcare management software.
• Strong organizational and multitasking capabilities to handle high volumes of requests.
• Attention to data accuracy and confidentiality in line with HIPAA requirements.

Responsibilities

• Insurance verification to determine pre-authorization requirements.
• Initiate and manage the pre-certification process for procedures and medications.
• Maintain accurate records of approvals and denials and communicate with providers, patients, and insurers.
• Collaborate with healthcare providers, billing, and admin staff to gather needed information.
• Monitor status of requests, address denials, and assist with appeals as needed.
• Stay updated on insurance regulations to ensure compliant processes.

Skills

Communication skills

Computer skills

Organization

Attention to detail

HIPAA knowledge

Tools

Healthcare software

Job description

The Center for Pain is seeking a Pre-Certification Specialist to verify patient insurance, initiate pre-certification, and manage approvals and denials. You will communicate with providers, patients, and insurers and collaborate with billing and administrative teams to gather necessary information.

The ideal candidate has strong communication, organizational, and HIPAA-compliant data-management skills, with experience in healthcare software.