Prior Authorization & Insurance Verification Specialist

ProMedica Health System; Toledo (OH); On-site; USD 60,000 - 75,000; Full time

Benefits offered by this job

Flexible benefits

Job summary

ProMedica is seeking a Pre-Certification Specialist in the Orthopaedics department at Wildwood Orthopaedic & Spine Hospital in Toledo, Ohio. You will perform prior authorization and certification for surgical and injection services with payers, while maintaining knowledge of related coding and medical criteria.

Applicants should have an associate degree or 5 years of billing/insurance verification experience, familiarity with ICD10 and CPT codes, and at least 5 years in a medical office

Qualifications

• Associate degree or 5 years of Billing/Insurance Verification experience.
• Familiarity with ICD10 and CPT codes applicable to services rendered.
• 5 years of relatable or equivalent experience in medical office

Responsibilities

• Perform prior authorization and certification for services with payers.
• Maintain a working knowledge of coding for surgeries and injections.
• Keep up-to-date with medical criteria relating to prior authorization requirements by third-party payers.

Skills

Billing/Insurance Verification

ICD10/CPT Coding

Medical Office Experience

Education

Associate degree

Job description

ProMedica is seeking a Pre-Certification Specialist in the Orthopaedics department at Wildwood Orthopaedic & Spine Hospital in Toledo, Ohio. You will perform prior authorization and certification for surgical and injection services with payers, while maintaining knowledge of related coding and medical criteria.

Applicants should have an associate degree or 5 years of billing/insurance verification experience, familiarity with ICD10 and CPT codes, and at least 5 years in a medical office