What are the responsibilities and job description for the Pre-Certification Specialist position at Maury Regional Health?
JOB TITLE: Pre-Certification Specialist
DEPT: Financial Clearance
LOCATION: MRMC- Plaza
SHIFT: 7:00am-3:30pm PRN (as needed)
MAURY REGIONAL HEALTH:
At Maury Regional Health, we are committed to delivering a reimagined health care experience — one that puts our patients at the front and center as we strive to deliver clinical excellence and compassionate care for every patient, every day.
WHY MAURY:
- 2024 Best Place to Work & 2024 Best Place for Working Parents
- Medical, Dental, Vision, Retirement Plans & PTO
- Educational Assistance, Tuition Reimbursement & Career Advancement Navigation
- Employee Discounts
- Childcare Services – Hospitots
- Adoption Assistance
For more information: About Maury Regional Health
JOB SUMMARY:
The Pre-Service areas of technical competencies should include Advanced knowledge of office equipment, computers, and insurance websites. Advanced knowledge of all healthcare insurance payers and authorization guidelines. Ability to communicate clinical documentation and insurance protocols for authorization. Create a positive impression for each patient, family member, visitor or staff while performing the tasks of scheduling and pre-certification. Schedule and obtain insurance pre-certification/pre-determination and evaluate medical necessity compliance prior to patients receiving medical services, ensuring accuracy and timeliness. Obtain demographic information and validate insurance. Answer and provide resolution for any questions received from patients, visitors, and staff. Within scope of job, requires critical thinking skills, decisive judgment, effective oral and written communication skills, and the ability to work with minimal supervision . Must be able to work in a fast-paced environment and take appropriate action.
JOB REQUIREMENTS:
·3 Years Related Required
·High School Diploma or Equivalent Required
·Associate’s Preferred
MISSION, VISION & VALUES:
MISSION: Clinical excellence. Compassionate care. Every patient. Every day.
VISION: To be the trusted choice for health and wellness in southern Middle Tennessee by delivering a safe, seamless and patient-centered experience.
VALUES:
W – Wholeness: Wellness-centered care of mind, body & spirit for our patients & health care team.
E – Empathy : Understanding the feelings of others as we walk with them on their path to wellness.
C – Community: Creating relationships, connections & trust.
A – Advocacy: Defending the rights of all to be heard.
R – Respect: Treating everyone with dignity & respect.
E – Equity: Providing each individual a fair opportunity to achieve their full potential.
STRATEGIC ANCHORS:
- Quality patient care
- Highly effective teams
- Stewardship of resources
- Innovative culture
Maury Regional Health is committed to the principles of Equal Employment Opportunity in all aspects of the employer/employee relationship. Maury Regional Health grants equal employment opportunities to all qualified persons without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), national origins (including ancestry), genetic information, disability, age, military/national guard/veteran status, sexual orientation, gender identity, or gender expression, or other status protected by state or federal law. Statements made by applicants for employment on this application form will be checked for accuracy. Maury Regional Health campuses are tobacco-free. All tobacco use is prohibited.
