What are the responsibilities and job description for the Pre-Certification Specialist I position at GI Alliance?
GI Alliance is seeking an experienced Pre-Certification Specialist I.
Duties of this position include, but are not limited to, the following:
Position purpose
Responsible for the communicating with insurance companies to ensure proper certification/authorization is obtained prior to patients appointment and all scheduled tests and procedures.
Responsibilities/Duties/Functions/Tasks:
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Obtain all requests for precertification and prior authorization from insurance companies for appointments, scheduled tests and procedures.
- Contact insurance companies as needed to obtain precertification and record on form data entry.
- Communicates necessary patient financial information with appropriate office and billing personnel in an efficient, timely and accurate manner.
- Documents, within the practice management system, all required information to include financial responsibility.
- Verify waivers have been signed as needed for tests and procedures prior to date of service.
- Communicate with staff on any adjustments on precertification.
- Light data entry and other related office duties.
Other duties as assigned.
Qualifications
Education: High School diploma or GED.
Experience: Minimum of two (2) years of pre-certification experience required.
Requirements for Level I Status:
- Entry level (1-4 years experience) and/or meet the basic requirements of the job with the need for additional supervision.
- Excess of 4 years experience if meeting only the basic requirements of the job with need for additional supervision.
Additional Qualifications: Proficient knowledge of medical terminology, ICD-10 and CPT-4 codes.
Performance Requirements:
- Excellent communication skills, both written and verbal.
- Proficient technical (computer) skills.
- Ability to multi-task and prioritize.
- Self-motivated with initiative.
- Strong sense of ethics.
Equipment Operated: This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.
Work Environment: This job operates in professional office environments.
Physical Requirements: While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; talk or hear; and taste or smell. The employee must occasionally lift or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus.
GI Alliance is an Equal Opportunity Employer. We are committed to creating an inclusive, welcoming, and equitable work environment. Our company values and celebrates the diversity of our physicians, staff and patients. We firmly believe our service is greatly enriched by our diversity of thought, experience, perspective, culture, and background.
Please Note: All job offers are contingent on the successful completion of pre-employment criminal history check.
NOTE: ALL APPLICATIONS MUST BE COMPLETED IN FULL FOR CONSIDERATION.
No phone calls or agencies, please.
EEO/AA-M/F/disabled/protected veteran
