Precertification Representative

Orthohealthkc; Kansas City (MO); On-site; USD 42,000 - 56,000; Full time

Job summary

Orthohealthkc in Kansas City, MO is seeking a detail-oriented Precertification Representative to obtain precertifications and prior authorizations from insurance companies to ensure timely processing of medical services.

You will verify patient coverage, communicate with providers, patients, and insurers, maintain records, and follow up on pending approvals. This role is based in our Kansas City office, with occasional phone/email interactions and independent task management.

Qualifications

• Previous experience in medical billing, insurance verification, or precertification is a plus.
• Strong communication and interpersonal skills.
• Detail-oriented with strong organizational skills.
• Proficient in using computer systems and software related to healthcare administration.

Responsibilities

• Contact insurance companies to obtain precertifications and prior authorizations for medical procedures and services.
• Verify patient insurance coverage and eligibility.
• Communicate with healthcare providers, patients, and insurance representatives to gather necessary information.
• Maintain accurate records of all precertification requests and approvals.
• Follow up on pending authorizations to ensure timely completion.
• Assist in resolving any issues related to insurance denials or delays.
• Stay updated on insurance policies, procedures, and requirements.

Skills

Communication skills

Interpersonal skills

Detail-oriented

Organizational skills

Healthcare software

Job description

Location: Kansas City, MO

Job Id:115

# of Openings:1

Job Description

We are seeking a detail-oriented and customer-focused Precertification Representative to join our team in Kansas City, MO. The ideal candidate will be responsible for obtaining prior authorizations and precertifications from insurance companies to ensure timely and accurate processing of medical services.

Responsibilities

• Contact insurance companies to obtain precertifications and prior authorizations for medical procedures and services.
• Verify patient insurance coverage and eligibility.
• Communicate with healthcare providers, patients, and insurance representatives to gather necessary information.
• Maintain accurate records of all precertification requests and approvals.
• Follow up on pending authorizations to ensure timely completion.
• Assist in resolving any issues related to insurance denials or delays.
• Stay updated on insurance policies, procedures, and requirements.

Qualifications

• Previous experience in medical billing, insurance verification, or precertification is a plus.
• Strong communication and interpersonal skills.
• Ability to work independently and manage multiple tasks efficiently.
• Proficient in using computer systems and software related to healthcare administration.
• Detail-oriented with strong organizational skills.

This position is based in our Kansas City office and may require occasional interaction with healthcare providers and insurance representatives via phone and email.