Surgical Precertification & Insurance Verification Specialist

Ortholonestar; Houston (TX); On-site; USD 25,000 - 30,000; Full time

Job summary

Ortholonestar in Houston, TX is seeking an experienced Precert Verification Coordinator to ensure accuracy in patient accounts and maximize reimbursement. You will educate patients or responsible parties about financial responsibilities and insurance issues to streamline arrivals at clinics and surgery facilities.

Responsibilities include obtaining authorizations, completing surgical estimates, updating patient records, and guiding front desk staff on insurance matters.

Qualifications

• High school diploma or equivalent.
• Associate degree in healthcare administration or a related field.
• Familiarity with medical terminology and insurance coding.
• Previous experience in a healthcare or insurance-related role.
• Strong attention to detail and accuracy in data entry.
• Experience with electronic medical record (EMR) system.

Responsibilities

• Complete all surgery verification, authorization/precertification to improve customer satisfaction allowing no more than 2 weeks.
• Contacts insurance company for authorization/precertification requirement, initiate request and deliver pertinent medical records to expedite process; obtains patient eligibility and benefits via phone or online portal.
• Completes and provides surgical/injectable estimates to patients.
• Confirms all eligible appointments and scans all pertinent documentation to patient’s chart.
• Notates pertinent information in the system regarding patient insurance verification/pre-certification status and patient financial responsibility.
• Notifies front desk staff and clinical team of any problematic insurance issue that may lead to clinic delay.
• Provides patient collection advice & benefit interpretations to AOSM staff and patients when necessary.
• Displays the highest level of customer service, attentiveness and consideration possible in all surgery cases.
• Any additional duties as assigned

Skills

Attention to detail

Data entry accuracy

Healthcare terminology

Insurance coding

Education

High school diploma or equivalent

Associate degree in healthcare administration or related field

Tools

EMR system

Job description

Ortholonestar in Houston, TX is seeking an experienced Precert Verification Coordinator to ensure accuracy in patient accounts and maximize reimbursement. You will educate patients or responsible parties about financial responsibilities and insurance issues to streamline arrivals at clinics and surgery facilities.

Responsibilities include obtaining authorizations, completing surgical estimates, updating patient records, and guiding front desk staff on insurance matters.