Precertification & Prior Authorization Pro

SGMC Health; Valdosta (GA); On-site; USD 32,000 - 52,000; Full time

Job summary

SGMC Health is seeking a dedicated administrative professional to obtain precertification and prior authorization for tests and procedures. You will review information for accuracy, upload documentation into the EHR, and monitor authorization requests to ensure timely processing.

You will also assist front office reception and customer service duties, contributing to department operations. A high school diploma and hospital/medical office experience are preferred.

Qualifications

• High school graduate preferred.
• Minimum 1 year prior administrative experience or equivalent; preferable in a hospital or medical office setting to include working knowledge of insurance and managed care.
• Must have excellent computer (technical and systems) skills & knowledge: PC and Windows literacy required, as well as Microsoft Office applications - Outlook, Word, Excel, etc.
• Prior use of medical office software database preferred.
• Must possess excellent communication and interpersonal skills, and must be able work effectively as part of a team and respond well to supervision.
• Self-motivated, showing initiative to tackle important issues, problems and tasks.
• Attention to detail skills are critical; ability to manage multiple tasks, meet deadlines and be flexible in order to adapt to variety on the job.

Responsibilities

• Obtain precertification and/or prior authorization for each patient for tests/procedures ordered by the Surgeon, preferably prior to scheduled appointment.
• Review information for accuracy related to precertification and/or prior authorization numbers and supporting documents.
• Upload authorization numbers, time spans, and documentation into SGMC Health's EHR system upon verification of procedures.
• Monitor and track authorization requests and expiring authorizations.
• Document in SGMC Health's EHR system as the official medical record following guidelines.
• Assist with front office reception and various customer service duties.
• Other duties as assigned by Practice Manager.

Skills

Administrative experience

Communication

Multitasking

Teamwork

Attention to detail

Computer skills

Education

High school diploma

Tools

Microsoft Office

EHR software

Job description

SGMC Health is seeking a dedicated administrative professional to obtain precertification and prior authorization for tests and procedures. You will review information for accuracy, upload documentation into the EHR, and monitor authorization requests to ensure timely processing.

You will also assist front office reception and customer service duties, contributing to department operations. A high school diploma and hospital/medical office experience are preferred.