What are the responsibilities and job description for the Precertification Specialist position at TOTAL DERMATOLOGY?
Job Summary:
The Precertification Specialist is responsible for obtaining prior authorization/referral for all surgery and scheduled procedure orders/tasks by completing the precert process with all payers, notifying the patient of their financial obligation and documenting the task and patient record with details.
Essential Duties and Responsibilities:
- Pull tasks for simple precertification for treatments and surgeries
- Verify benefits, calculate patient's estimated out of pocket, and contact patient at least 3 days ahead of surgery
- Discuss payment plan requirements with patients if patient requests plan.
- Prepare payment plan form and provide it to front desk ahead of scheduled appointment(s)
- Note ledger with estimated patient responsibility.
- Answer patient calls and take patient credit card payments over phone.
- Rotate calling telehealth patients to collect copayments
- Rotate posting mailed patient payments
- Assist with other duties, as needed
Education / Experience
- 2 years experience in a medical related field preferred
- 2 years medical prior authorization experience preferred
Skills
- Knowledge of payers, eligibility files, network vs out of network payer guidelines
- Understanding of payer guidelines for referral, authorization, patient responsibility
- Basic understanding of medical and surgical terms
- Basic understanding of CPT and ICD10 codes
- Excellent computer skills including Excel and Word
- Detail oriented with excellent organizational skills
- Excellent customer service skills
- Ability to multi-task, maintain a high volume, time sensitive workload
This Job Description is intended to describe the general nature and required work to be performed. It is not intended to be an exhaustive list of all responsibilities, duties and skills required.
Total Dermatology is an Equal Opportunity Employer.
Job Type: Full-time
Benefits:
- 401(k)
- Dental insurance
- Disability insurance
- Employee assistance program
- Employee discount
- Flexible spending account
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Retirement plan
- Vision insurance
Work Location: Hybrid remote in Birmingham, AL 35217