What are the responsibilities and job description for the Pre-Certification Specialist position at Mosaic?
Mosaic Life Care is a health care system in northwest Missouri. With a vision of transforming community health by being a life-care innovator, Mosaic places the holistic needs of patients first by providing the right care at the right time and place, offering high value and quality health care.
Mosaic has a wide array of benefits to meet each employee’s individual needs. Our benefits were designed by listening to people just like you. Mosaic also offers several perks with a focus on ensuring our employees feel valued, including concierge services, employee lounge, wellness programs, free covered parking, free on-site and virtual health clinics and many more. When paired with compensation and recognition, it is what continues to make us the employer of choice for employees at any stage of their journey.
- Pre-Certification Specialist
- Utilization Management
- Full Time Status
- Day Shift
- Pay: $16.15 - $21.81 / hour
- This position implements procedures and processes by which Mosaic performs its precertification and retro precertification reviews. Responsible for completing insurance notifications for inpatient procedures, inpatient medical stays, and OB deliveries. Assists in maintaining records and answering correspondence with great communication skills. Familiar with standard concepts, practices, and procedures of utilization management and medical precertification. Performs a variety of tasks. A certain degree of creativity and latitude is required.
- This position is employed by Mosaic Health System.
- Performs precertification in accordance with the hospitals UM plan to ensure adherence to hospital and payer regulations.
- Reviews and processes all commercial, managed care and government payers’ precertification requirements by following established protocols, guidelines and qualifiers.
- Manages admission and retrospective precertification requirements.
- Follows up on all requests for information and documentation in a timely manner.
- Assists in the collection of information for insurance appeals of denied accounts.
- High School Diploma
- Familiarity with medical terminology. Familiarity with managed healthcare or hospital delivery systems preferred
Salary : $16 - $22
