What are the responsibilities and job description for the Precertification Specialist position at Haydel Spine Pain & Wellness Center?
Pre-Certification Specialist
Haydel Spine Pain & Wellness Center is a thriving medical practice located in Houma, LA. We are seeking a full-time Pre-Certification Specialist to join our team. We are a fast-paced medical practice looking for an enthusiastic individual with a positive demeanor who is committed to providing exceptional customer service to our patients and providers. Must be a team player and have an excellent work ethic.
Job Description: A full-time position available for a PRE-CERTIFICATION specialist. Knowledge of procedure authorization and its direct impact on the practice’s revenue cycle * Understanding of payer medical policy guidelines while utilizing these guidelines to manage authorizations effectively * Basic understanding of human anatomy, specifically musculoskeletal * Proficient use of CPT and ICD-10 codes * Excellent computer skills including Excel, Word, and Internet use * Detail oriented with above average organizational skills * Plans and prioritizes to meet deadlines * Excellent customer service skills; communicates clearly and effectively * Ability to multitask and remain focused while managing a high-volume, time-sensitive workload
Responsibilities:
- Obtaining pre-certifications and/or prior authorizations for all procedural orders, diagnostic imaging orders and durable medical equipment by successfully completing the authorization process with all commercial payers/attorneys/workers compensation, etc.
- Review chart documentation to ensure patient meets medical policy guidelines
- Prioritize incoming authorization requests according to urgency.
- Obtain authorization via payer website or by phone and follow up regularly on pending cases
- Maintain individual payer files to include up to date requirements needed to successfully obtain authorizations
- Initiate appeals for denied authorizations
- Respond to clinic questions regarding payer medical policy guidelines
- Confirm accuracy of CPT and ICD-10 diagnoses in the procedure order
- Contact patients to discuss authorization status
- Other duties as assigned
Job Type: Full-time
Pay: $14.00 - $17.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Disability insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Ability to Commute:
- Houma, LA 70360 (Required)
Ability to Relocate:
- Houma, LA 70360: Relocate before starting work (Required)
Work Location: In person
Salary : $14 - $17