Pre-Certification Specialist (Surgery) (FT) - Remote

Optim Orthopedics; Savannah (GA); Hybrid; USD 38,000 - 48,000; Full time

Job summary

Optim Orthopedics in Savannah, GA is seeking a Pre-certification Specialist (Surgery) for a full-time remote position. The role focuses on pre-certing surgeries, coordinating with insurance providers, and ensuring ICD-9/CPT coding accuracy.

Ideal candidates have a High School Diploma or GED, completed Medical Terminology training, and at least one year in a medical office, with strong computer skills and a commitment to confidentiality.

Qualifications

• High School Diploma or GED required.
• Successful completion of a course in Medical Terminology.
• Minimum of one year experience in a Medical Office.
• Computer experience required.

Responsibilities

• Reviews patients’ medical records.
• Works with medical staff coordinating medical information and patient charts.
• Pre-certing all surgeries with the appropriate insurance company as required by ICD-9 code.
• Follows up with insurance companies to ensure coverage is in effect.
• Documents actions and maintains permanent records in patients’ charts.
• Answers patient questions regarding precert status of surgeries.
• Maintains confidentiality of sensitive information.

Skills

Medical terminology

Insurance industry knowledge

Typing / keyboarding

Confidentiality

Communication

Education

High School Diploma or GED

Medical Terminology course

Tools

Computer experience

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Pre-Certification Specialist (Surgery) (FT) - Remote

Full-time Regular Remote, Savannah, GA, US

7 days ago Requisition ID: 2718

JOB TITLE: Pre-certification Specialist

GENERAL SUMMARY OF DUTIES: Pre-certs all surgeries prior to day of surgery and follows up with insurance companies if diagnosis or procedures changed. Must be familiar with ICD-9 and CPT code books.

SUPERVISION RECEIVED: Reports directly to the Surgery Center Supervisor

SUPERVISION EXERCISED: None

TYPICAL PHYSICAL DEMANDS: Work may require sitting for long periods of time; also stooping, bending and stretching for files and supplies. Occasionally lifting files or paper weighing up to 30 pounds. Requires manual dexterity sufficient to operate a keyboard, type, operate a calculator, telephone, copier and other such office equipment as necessary. Vision must be correctable to 20/20 and hearing must be in the normal range for telephone contacts. It is necessary to view and type on computer screens for long periods and to work in an environment which can be very stressful.

TYPICAL WORKING CONDITIONS: Work is performed in an office environment. Involves frequent contact with staff, patients, insurance company representatives and the public. Work may be stressful at times. Contact may involve dealing with angry or upset people.

DUTIES: (This list may not include all of the duties assigned).

• Reviews patients’ medical records
• Works with medical and other staff in coordinating medical information and patient charts
• Responsible for pre-certing all surgeries, if required by ICD-9 code with the appropriate insurance company
• Follows-up with insurance companies ensuring that coverage is in effect
• Documents all actions and maintains permanent record in patients’ chart
• Answers patient questions and inquiries regarding the precert status of their surgeries
• Maintains strict confidentiality of sensitive information
• Performs related work as required

PERFORMANCE REQUIREMENTS:

Knowledge, Skills & Abilities:

Knowledge of medical terminology. Knowledge of grammar, spelling, and punctuation to type correspondence. Knowledge of insurance industry. Skill in operating a computer and photocopy machine. Ability to read, understand, and follow oral and written instruction. Ability to maintain confidentiality of sensitive information. Ability to sort and file materials correctly by alphabetic or numeric systems. Ability to speak clearly and concisely. Ability to establish and maintain effective working relationships with patients, employees, and the public.

EDUCATION: 1. High School Diploma or GED

2. Successful completion of a course in Medical Terminology

EXPERIENCE: 1. Minimum of one year experience in a Medical Office

2. Computer Experience

CERTIFICATE/LICENSE: None

ALTERNATIVE TO MINIMUM QUALIFICATIONS:

Additional appropriate education may be substituted for experience.