What are the responsibilities and job description for the Pre Cert Coordinator position at Medulla?
Pre-Certification Coordinator
TVG-Medulla, LLC provides support and services to two comprehensive chiropractic care companies, Chiro One Wellness Centers and MyoCore Personalized Pain Care, both industry leaders in evidence-based, patient outcomes-centered care.
Interested in taking on a new role? We are looking for an entry-level Pre-Certification Coordinator to join our team! We will provide two weeks of training so that you can become familiar with the role, the patients, and the company! Please see the information below to learn more -
General Description
Maintain daily departmental operations around pre-certification/pre-authorization of chiropractic, physical therapy, and durable medical equipment benefits.
Essential Functions and Responsibilities
- Verify insurance coverage on the phone and on web portals as requested for chiropractic, physical therapy and durable medical equipment upon request to determine benefits and if pre-certification is needed.
- Open pre-certifications/pre-authorizations with insurance companies when needed.
- Follow up with insurance companies on statuses of open pre-certification requests.
- Communicate with clinical teams regarding information needed for and statuses of pre-certifications.
- Monitor verification request portal and designated email accounts.
- Learn insurance policy-specific pre-certification procedures and guidelines.
- Update logs/prepare special reports.
- Support other functional areas, like Medical Records and Insurance Verifications, in the RCM department as needed.
- Ensure all communication is clear, professional, and branded.
- Notify management of any unusual scenarios, possible compliance concerns or recurring issues.
Minimum Qualifications
- High School Diploma or GED
- Exceptional computer skills
- Proficiency in Microsoft Office (especially Excel)
- Ability to professionally speak via phone for extended periods of time
- Be a Team Player with a can-do-attitude
Preferred Qualifications
- Basic knowledge of insurance benefits
- Two or more years of insurance, billing, or related experience
Job Competencies
- Ability to multi-task
- Strong attention to detail
- Ability to work in a fast-paced environment
- Excellent follow through skills
- Exceptional written and verbal communication skills.
- Ability to be professional during any difficult situations.
Disclaimer
All team members agree to consistently support compliance and TVG-Medulla, LLC policies and Standards of Excellence with regard to maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, adhering to applicable federal, state, and local laws and regulations, accreditation and licenser requirements (if applicable), and Medulla procedures and protocols. Must perform other related duties and assist with project completion as needed. Team member may be required to provide necessary information to complete a DMV (or equivalent agency) background check.
