Trauma Surgery Pre-Cert Specialist | Outpatient Center

Charleston Area Medical Center; Charleston (WV); On-site; USD 42,000 - 56,000; Full time

Job summary

Charleston Area Medical Center in Charleston, WV seeks a Pre-Certification Specialist for the Trauma Surgery Outpatient Surgery Center. You will review charts daily to determine pre-certification or referrals, gather insurance data, and coordinate with Medicare and other carriers to obtain necessary authorizations.

You will schedule procedures, prepare notes and letters, maintain billing information, and cross-train for front desk and medical assistant duties, ensuring accurate coding with

Qualifications

• Positive customer service and co-worker relations are expected.
• Ability to participate in quality improvement activities and follow policies.

Responsibilities

• Daily review of charts to determine pre-certification/authorization or referrals.
• Review insurance information to determine medical necessity requirements.
• Correspond with Medicare and various insurers to facilitate data for precertification.
• Perform clerical duties including letters to patients, carriers and physicians.
• Schedule surgeries and communicate information to relevant parties.
• Establish new patient accounts in billing software and forward information for charting.
• Maintain knowledge of ICD-10, CPT and HCPCS codes.
• Cross-train for front desk and medical assistant roles.
• Schedule all procedures and manage funds.

Skills

Customer service

Communication

Teamwork

Attention to detail

Education

High School Diploma or GED

Tools

Billing software

Job description

Charleston Area Medical Center in Charleston, WV seeks a Pre-Certification Specialist for the Trauma Surgery Outpatient Surgery Center. You will review charts daily to determine pre-certification or referrals, gather insurance data, and coordinate with Medicare and other carriers to obtain necessary authorizations.

You will schedule procedures, prepare notes and letters, maintain billing information, and cross-train for front desk and medical assistant duties, ensuring accurate coding with