What are the responsibilities and job description for the Pre-Certification Specialist position at Arlington Orthopedic Association?

Job Description

Description :

RESPONSIBILITIES INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING :

Verifies insurance coverage to ascertain deductible and coinsurance amounts, obtaining precertification / authorization for durable medical equipment and other services as needed.
Notifies patients of expected financial responsibility that will be due at the time of service.
Schedules pre-authorized services and follow-up office visits as needed.
Provides explicit instructions to patients regarding time of arrival, place of service, and documentation necessary for office visits.
Enters benefits and precertification / authorization into EMR system (Referral Management).
Coordinates with referring physician offices when necessary to pre-authorize services.
Coordinates with AOA business office to evaluate and resolve reimbursement issues.
Maintains work area in a neat and orderly manner at all times.
Attends scheduled staff meetings.
Availability to work in the office setting Monday-Friday.
Additional responsibilities as assigned by Director of CBO.

Requirements

EDUCATIONAL REQUIREMENTS :

High School Diploma / GED or equivalent experience.

QUALIFICATIONS AND EXPERIENCE

Computer literate, with keyboard skills-working knowledge of practice management software.

One or more years of DME experience.

One or more years’ experience in insurance verification / precertification in a medical office or hospital setting preferred.

Knowledge of medical terminology.

One year or more of work experience in various areas of medical insurance preferred.

Knowledge of CPT and ICD-9 coding of DME.

Pleasant speaking voice and demeanor.

Neat, professional appearance.

Ability to perform in a highly stressful situation.

Ability to multitask.

Ability to focus and maintain direction in the tasks at hand under pressure.

Ability to establish effective working relationships with patients, physicians, insurance representatives and other medical support staff.

Background in medical terminology and orthopedics preferred.

Ability to analyze various medical situations for scheduling purposes

Requirements :

Dress Code : Work provided Top and professional bottoms.

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Arlington Orthopedics Associates, Arlington, TX

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