Precertification Assistant - Precertification - FT 1.0 (80 hrs biweekly) (59260)

Memorial Health System - Ohio; Reno (OH); On-site; USD 40,000 - 55,000; Full time

Job summary

A leading healthcare provider seeks a Precertification Assistant in Reno, OH. The role involves supporting the review of medical tests and assisting with insurance authorization processes. Ideal candidates will possess keen knowledge of healthcare regulations and prior experience in medical settings.

Benefits

Affordable and comprehensive benefit package

Bonus eligibility for qualifying full-time employees

Qualifications

• Minimum of 2 years’ experience in hospital or medical office preferred.
• Previous education in medical terminology, anatomy, and physiology preferred.
• Ability to handle medical insurances and scheduling.

Responsibilities

• Assists with review of scheduled tests and surgeries.
• Verifies insurance information and coverage.
• Obtains authorizations and checks medical necessity.

Skills

Knowledge of insurance issues

Good telephone skills

Clerical skills

Interpersonal skills

Typing at 40 wpm

Education

High School Diploma or GED

Medical office program certification

Medical terminology education

Anatomy and physiology education

Job description

Join to apply for the Precertification Assistant - Precertification - FT 1.0 (80 hrs biweekly) (59260) role at Memorial Health System - Ohio

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Join to apply for the Precertification Assistant - Precertification - FT 1.0 (80 hrs biweekly) (59260) role at Memorial Health System - Ohio

Description

In an environment of continuous quality improvement, the Precertification Assistant is responsible for assisting with the review of scheduled tests and surgeries, to verifying insurance information and coverage, determine authorizations, medical necessity is obtained, or medical coverage, for proper payment of testing. Exhibits the MHS Standards of Excellence and exercises strict confidentiality at all times.

Job Details

Job Location: Reno, OH

Position Type: Full Time

Salary Range: Undisclosed

Job Shift: 8-Hour Day Shift

Job Category: Clinical Support

Description

In an environment of continuous quality improvement, the Precertification Assistant is responsible for assisting with the review of scheduled tests and surgeries, to verifying insurance information and coverage, determine authorizations, medical necessity is obtained, or medical coverage, for proper payment of testing. Exhibits the MHS Standards of Excellence and exercises strict confidentiality at all times.

Job Functions

• Acquires skills and maintains knowledge of system applications/websites used in precertification.
• Determines if test/procedure requires authorization.
• Reviews order for completeness.
• Obtains appropriate authorization, checks medical necessity for Medicare patients, reviews Commercial Insurance medical policies to ensure proper payment from Insurance is received.
• Contacts the provider’s office via telephone or task to place a patient’s testing on hold if authorization isn’t obtained.
• Notifies the providers office if a Peer to Peer option is available.
• Tracks authorization information in all tabs of the authorization module.
• Assumes all other duties and responsibilities as necessary.
  
  

Qualifications

Minimum Education/Experience Required:

• Minimum of 2 years’ experience in hospital, medical office or clinic setting in registration dealing with insurance issues and/or scheduling experience preferred.
• Previous education in medical terminology, anatomy and physiology, or graduate/certification from medical office program preferred.
• If no previous education, anatomy and physiology will be required within 6 months of employment.
  
  

Special Knowledge, Skills, Training

• Must have or be able to acquire and retain good knowledge of commercial, federal and state payor requirements.
• Needs good telephone voice and skill in handling business transactions, including irate patients.
• Ability to work with computerized system, also basic clerical and interpersonal skills and typing at 40 wpm.
• Ability to read, write and do math as generally demonstrated by a high school diploma or GED.
  
  

Compensation Details: Education, experience, and tenure may be considered along with internal equity when job offers are extended.

Benefits: Memorial Health System is proud to offer an affordable, comprehensive benefit package to all full time and flex time employees. To learn more about the many benefits we offer, please visit our website at www.mhsystem.org/benefits.

Bonus Eligibility: Available to qualifying full or flex time employees. Eligibility will be determined upon offer.

Memorial Health System is an equal opportunity provider and employer.

If you wish to file a Civil Rights program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, found online at https://www.ocio.usda.gov/document/ad-3027, or at any USDA office, or call [phone] to request the form. You may also write a letter containing all of the information requested in the form. Send your completed complaint form or letter to us by mail at U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, S.W., Stop 9410, Washington, D.C. 20250-9410, by fax [phone] or email at [e-mail].

• Memorial Health System is a federal drug-free workplace. This policy prohibits marijuana use by employees.

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Human Resources

• Industries

  Hospitals and Health Care

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