PRECERTIFICATION PRIOR AUTHORIZATION SPEC, SPN-SCHEDULING

Sgmc-Health-1; Valdosta (GA); On-site; USD 32,000 - 42,000; Full time

Benefits offered by this job

Low Healthcare Insurance Premiums

401(k) with employer match

Paid Time Off (PTO)

Employee discounts

Company paid life insurance

Short-Term and Long-Term Disability

Tuition Reimbursement

On-the-job training and skills

Job summary

SGMC Health in Valdosta, GA is seeking an administrative specialist to manage precertification and prior authorization for tests and procedures ordered by surgeons. Responsibilities include coordinating with patients, ensuring timely authorizations and accurate documentation in the EHR.

The role emphasizes attention to detail, multitasking, and teamwork, with a weekday day shift from 8:00 to 17:00 in the Professional Building. On-site work with opportunities for development.

Qualifications

• High school graduate with healthcare admin interest.
• At least 1 year of administrative experience in medical settings.
• Strong computer skills including Outlook, Word, Excel.
• Knowledge of insurance and managed care helpful.

Responsibilities

• Obtain precertification and prior authorization for testing and procedures.
• Verify accuracy of authorization information and supporting documents.
• Upload authorization data into SGMC Health's EHR system.
• Monitor and track pending and expiring authorizations.
• Provide front office support and general customer service.
• Perform other duties as assigned by Practice Manager.

Skills

Attention to detail

Multitasking

Communication skills

Teamwork

Self-motivation

Flexibility

Initiative

Education

High School Diploma

Tools

Microsoft Office

Outlook

Excel

EHR software

Medical office software database

PC and Windows literacy

Job description

Description

WHAT IT'S LIKE AT SGMC HEALTH

Purpose

No matter your role or area that you work in, at SGMC Health we are collectively working towards goals that will make our community a better place.

Excellence

We strive to do the right thing the right way, are accountable in all we do, require competence of our people, and are compassionate in our service.

Team Spirit.

We encourage team effort, support personal and professional development, acknowledge individual talents and skills, and support innovation and empowerment.

Award Winning Performance.

We are committed to providing the best care possible and we are proud to be recognized locally, statewide, and nationally for the exceptional care that our staff provides.

WHY YOU WILL LOVE SGMC HEALTH

SGMC has great benefit options, depending on the role that you are going into– including healthcare, supplementary benefits, ways to save for the future, opportunities for career advancement, and opportunities to expand your skill set. Some of these great benefit options are listed below:

• Low Healthcare Insurance Premiums
• 401(k) with employer match
• Paid Time Off (PTO)
• Employee discounts
• Company paid life insurance
• Short-Term and Long-Term Disability
• Cancer Insurance
• Accident Insurance
• Pet Insurance
• Tuition Reimbursement
• On-the-job training and skills development
• Opportunities for growth and advancement
• Employee Assistance Program

JOB LOCATION :

Professional Building

DEPARTMENT:

SPN - SCHEDULNG

SCHEDULE:

Full Time, 8 HR Day Shift, M-F 0800-1700

POSITION SUMMARY

Responsible for obtaining precertification and/or prior authorization for each patient for which testing and/or procedures have been ordered by the Surgeon, prior to services being rendered, using appropriate diagnoses and procedure codes. The precertification and/or authorization must be obtained on each patient; preferably prior to their scheduled appointment. If not able to obtain precertification and/or authorization, specialist must contact the patient to reschedule their appointment. Responsible for reviewing for accuracy of information requested and received in regard to precertification and/or prior authorization numbers received, as well as supporting documents. Responsible for uploading into SGMC Health's EHR software system, authorization numbers, time spans/number of procedures, etc. and supporting documentation upon verification that procedures are authorized as requested. Responsible for monitoring and tracking of authorization requests and expiring authorizations. Responsible for the use of and, documentation in, SGMC Health's EHR software system as the official medical record, following appropriate guidelines for documenting. Responsible for contributing to department development. Perform front office reception and various customer service duties. Other duties as identified and assigned by Practice Manager.

KNOWLEDGE, SKILLS & ABILITIES

• 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. as well as a variety of other office machines.
• 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; ability to cross train to other functions as necessary.
• Requires flexibility in work scheduled for accountability expectations for operations and process management in a customer focused business.

WORKING CONDITIONS - ADA INFORMATION

Generally regular work schedule during normal office hours. Comfortable setting indoors. May be subjected to high levels of stress. Must be able to sit for prolonged periods of time. Moderate heavy lifting (0-25 lbs.), reaching, stooping, pushing, pulling, bending and twisting. Must be able to operate office equipment to include FAX, copier, and computer.

SEE WHAT ALL OF THE HYPE IS ABOUT

https://www.youtube.com/watch?v=_DeqKw8xk54