PRECERTIFICATION SPECIALIST (11376)

First Urology, PSC; Jeffersonville (IN); On-site; USD 35,000 - 55,000; Full time

Benefits offered by this job

401(k) company contribution

Dental insurance

Health insurance

Vision

Company Paid Life insurance 20k

Company Paid AD&D 20K

Company Paid Long-Term Disability 60%

6 Days of Sick Time

8 Paid Holidays

10 Days of Vacation Time

Milestone Checks

Cabin/Condo for vacations

Job summary

First Urology, PSC in Jeffersonville, IN, seeks a Precertification Specialist to verify insurance benefits and obtain pre-authorization for medical services before they are provided. The role is full-time, in-office, Monday–Friday day shift, reporting to the Precertification Manager.

This position requires strong communication skills, attention to detail, and knowledge of medical terminology and insurance policies.

Qualifications

• Strong communication and customer service skills are essential.
• Experience with EMR/EHR systems is beneficial.
• Knowledge of medical terminology is advantageous.
• Must manage a high volume of work and meet deadlines.
• Experience in medical billing or insurance authorization is preferred.

Responsibilities

• Verify patient insurance eligibility and benefits for scheduled procedures.
• Obtain prior authorization from insurance carriers for medical services.
• Gather necessary medical documentation from physicians and staff to support authorization requests.
• Coordinate with patients, physicians, insurers, and facility staff as a liaison.
• Document all information in the practice management system and track authorizations, denials, and appeals.
• Follow up on pending authorizations and resolve issues that arise during the process.
• Explain coverage and financial responsibilities to patients.

Skills

Communication skills

Customer service

Attention to detail

Medical terminology

High volume workload management

Education

High school diploma or equivalent

Associate degree or higher preferred

Tools

EMR/EHR software

Job description

Precertification Specialist

Location(s): Jeffersonville
Department: Precertification
Job Type: Full Time, Non-Exempt
Schedule: Monday through Friday- In Office (Day Shift)

Reports to: Precertification Manager

About First Urology, PSC

As the largest urologic provider in the greater Louisville and southern Indiana area, First Urology offers comprehensive urologic care for men, women and children of all ages. At First Urology, our physicians are dedicated to finding solutions to a wide range of issues to help patients regain to the quality of life they deserve. Recent groundbreaking advancements include First Urologys utilization of High Intensity Focused Ultrasound as a game-changing technology in the treatment of prostate cancer. HIFU can provide precise and complete destruction of prostate cancer, while preserving normal bladder and erectile function for most men. As a Regional Center of Excellence, First Urology is the first practice in America to use the newly FDA approved Sonablate HIFU system. To find learn more about First Urology, go to www.1sturology.com

Why First Urology?

First Urology has been awarded Best Places to Work in Louisville and Southern Indiana by Business First of Louisville for eight years in a row! We offer competitive compensation, a strong 401k, generous PTO, employee vacation rentals, and a strong work-life balance supported by a no-nights/no-weekends schedule.

Position Summary:

This role is to verify a patient's insurance benefits and obtain pre-authorization for medical services or procedures, ensuring coverage before the service is rendered. Key duties include verifying eligibility, gathering necessary information from physicians, communicating with insurance companies, documenting all details, and informing patients about their coverage. This role requires strong communication, attention to detail, and knowledge of medical terminology and insurance policies.

Essential Functions and Responsibilities:

• Verify insurance and benefits: Confirm patient eligibility and benefits for scheduled procedures with various insurance carriers (e.g., Medicare, Medicaid, commercial).
• Obtain pre-authorization: Secure the required prior approval from insurance companies for medical services, prescriptions, or treatments.
• Gather information: Collect necessary medical documentation from referring physicians and clinical staff to support the authorization request.
• Communicate with stakeholders: Act as a liaison between patients, physicians, insurance representatives, and facility staff.
• Document and manage records: Accurately enter all information into the practice management system and maintain records of authorizations, denials, and appeals.
• Address issues: Follow up on pending authorizations, resolve problems, and handle any issues that arise during the process.
• Inform patients: Explain insurance coverage, authorization status, and any financial responsibilities to the patient.

Qualifications:

• High school diploma or equivalent is typically required, with an associate degree being a plus.
• Prior experience in medical billing, insurance authorization, or a similar role is strongly preferred.
• Strong communication and customer service skills are essential.
• Detail-oriented with basic computer skills, including experience with electronic medical records software and electronic health records (EHR).
• Knowledge of medical terminology is beneficial.
• Must be able to manage a high volume of work and meet deadlines.

Education and Certifications:

• High school diploma or equivalent (required); associate degree or higher a plus.

Benefits:

• 401(k) company contribution of 7.5% annual salary (whether you contribute or not)
• Dental insurance
• Health insurance
• Vision
• Company Paid Life insurance 20k
• Company Paid AD&D 20K
• Company Paid Long-Term Disability 60%
• 6 Days of Sick Time
• 8 Paid Holidays
• 10 Days of Vacation Time
• Milestone Checks
• Cabin/Condo for vacations

EEOC Statement:

First Urology provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training. May be required to undergo background check and/or drug screen.