Verification & Precertification Specialist

Ellis and Badenhausen Orthopaedics; Louisville (KY); On-site; USD 42,000 - 62,000; Full time

Job summary

Ellis & Badenhausen Orthopaedics PSC in Louisville, KY, is seeking candidates for future opportunities as Verification & Precertification Specialists. This role supports financial integrity of patient accounts, communicates with patients about financial obligations, and helps ensure smooth clinic visits and procedures.

The position emphasizes HIPAA compliance, accurate coding for insurance processing, and collaboration with staff to resolve insurance issues and maximize reimbursement.

Qualifications

• Communicate with patients about financial obligations
• Process pre-certification and insurance verifications
• Ensure HIPAA and OSHA compliance in daily tasks

Responsibilities

• Contact insurance companies for pre-certification requirements
• Initiate authorization requests and submit medical records
• Verify patient eligibility and benefits
• Code surgical procedures accurately for insurance processing
• Provide cost estimates to patients and explain coverage

Skills

Insurance verification

Precertification

Communication with patients

HIPAA compliance

Analytical thinking

Job description

Join Our Talent PipelineWhere People Make the Difference Ellis & Badenhausen Orthopaedics PSC is building a pipeline of qualified candidates for potential future opportunities as a Verification & Precertification Specialist While there is not an immediate opening we welcome applications from individuals who may be interested in joining our team as future staffing needs arise At Ellis & Badenhausen Orthopaedics we believe our success is driven by the right peopleindividuals with the right aptitude a positive attitude and an entrepreneurial spirit We are committed to providing the Louisville and southern indiana community with the highest level of orthopaedic care By maintaining a skilled experienced team and staying at the forefront of medical technology and research we ensure that patient care remains our primary focus

About the Role

As a Verification & Precertification Specialist you would play a critical role in supporting the financial integrity of patient accounts and maximizing reimbursement This position communicates with patients and responsible parties regarding financial obligations and insurance related matters helping create a smooth and efficient experience as patients prepare for clinic visits or surgical procedures If you are passionate about making a difference in patients lives and thrive in a collaborative fast paced environment we would love to learn more about you and consider you for future opportunities

Key Responsibilities

Insurance Authorization & Verification

• Contact insurance companies for pre certification requirements
• Initiate authorization requests and submit medical records such as chart notes imaging reports and op notes
• Confirm patient eligibility and benefits via websites and phone
• Code surgical procedures accurately for insurance processing

Communication with Patients

• Provide surgical cost estimates to patients and explain insurance benefits
• Offer patient collection advice based on coverage and procedure details
• Update patient information in the system including insurance details and demographics

Documentation & Record Keeping

• Scan and upload pertinent medical records to patient charts
• Maintain detailed notes on insurance verification and pre certification statuses
• Ensure timely documentation of insurance and patient communications

Problem Identification & Resolution

• Identify insurance related issues that could delay surgery and communicate with relevant staff
• Report and elevate compliance or regulatory issues to the Office Manager

Customer Service & Compliance

• Provide high level customer service to patients insurance companies and internal teams
• Ensure adherence to HIPAA and OSHA regulations
• Stay informed on relevant laws and industry policies to maintain compliance

Collaboration & Efficiency

• Collaborate with coworkers physicians and external partners to enhance workflow
• Constantly seek improvements in efficiency and risk reduction

Analytical & Decision Making Skills

• Review and interpret data for accuracy and compliance
• Make informed decisions based on available information and regulatory requirements

We are an equal opportunity employer.

Ellis & Badenhausen Orthopaedics PSC is an equal opportunity employer.

All qualified applicants will receive consideration without regard to race creed gender marital status sexual orientation color religion national origin age disability veteran status or any other status protected under local state or federal laws.

Applicants must be eligible to work in the USA.