POSITION: Precertification Specialist
REPORTS TO: Practice Manager
REVIEWED BY: Practice Manager and Human Resources
REVIEW CATEGORY: Non Clinical Patient Care
REVISION DATE: 03/01/2020
POSITION SUMMARY: Obtains insurance precertifications and prior authorizations for patients prior to rendering services such as, but not limited to, procedures, injections, medications, infusions, DME, surgery, and diagnostic testing and imaging appropriate for department.
POSITIONS SUPERVISED: None.
ESSENTIAL FUNCTIONS AND JOB RESPONSIBILITIES:
High school diploma or equivalent required.
Knowledge, Skills, and Abilities:
Prior computer experience and ability to navigate in systems required. Prefer previous procedure scheduling with strong knowledge of insurance requirements and prior medical office experience. Position requires constant and frequent sound judgment and response. Must have excellent phone communication skills; detailed focus and quality follow through; and ability to successfully multi-task.
ADA JOB REQUIREMENTS:
Light Work - Exerting up to 20lbs of force occasionally, and/or up to 10lbs of force frequently, and/or a negligible amount of force constantly to move objects. If the use of arm and/or leg controls requires exertion of forces greater than that for sedentary work and the worker sits most of the time, the job is rated light work.
Close visual acuity to perform an activity such as preparing and analyzing data and figures, viewing a computer terminal, extensive reading.
The worker is subject to inside environmental conditions.