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Insurance and Benefits Pre-Certification Coordinator

The NEXus Pain Center
Newnan, GA Full Time
POSTED ON 2/5/2025
AVAILABLE BEFORE 4/4/2025

Job Description: 

Insurance & Benefits Pre-certification Coordinator

NEXus Pain Center is looking for a motivated, knowledgeable, experienced, multi-task expert, detail-oriented, organized person to process insurance paperwork and verify benefits for pain management patients.

ACTIONS PERFORMED:

1. Verify all insurance

2. Ensure all patients insurance benefits are updated and active

3. Scan insurance documents into patients’ charts

4. Call patients about updating their VA and Tricare referrals

5. Fax veteran referral for renewal

6. Provide patient with a 30-day referral reminder and have them sign it

7. Call insurance advisor on updating benefits

8. Education liaison for patients on insurance benefits and coverage

JOB DESCRIPTION:

  • Verify insurance benefits, obtain authorizations/re-certifications.
  • Provide appropriate follow-up communication with patients for adherence to Insurance plan benefits.
  • Review ordering physician note and injection order to ensure accuracy and consistency.
  • Participate in skill development and training though in-service programs to enhance knowledge level and to ensure mastery of processes.
  • Maintain a positive attitude and convey enthusiasm.
  • Involve in teamwork approach to responsibilities and activities within the clinic.
  • Responsible for pre-certification of patient insurance before care or treatment is scheduled.
  • Proficient in obtaining medical benefits by phone and by insurance portals.
  • Must be able to keep up with a fast-paced working environment.
  • Must demonstrate knowledge of Insurance coverage.
  • Detail oriented.

REQUIRED SKILLS AND EXPERIENCE:

  • Excellent verbal and written communication skills to include superior interpersonal and patient contact skills and excellent telephone manners.
  • Minimum of two years of experience with scheduling and insurance billing for medical services with general knowledge of ICD10 and CPT codes.
  • General knowledge of office procedures, equipment, and comprehensive computer skills.
  • Ability to follow doctors’ orders and thorough knowledge of injection therapy practice.
  • Work under minimal supervision and have ability to remain calm and exercise good judgment in stressful situations.
  • EMR experience needed. EClinical (ECW) experience a plus.
  • Previous experience as front office staff in physician’s office

EDUCATION, LICENSE, OR CERTIFICATION REQUIREMENTS:

  • High School Diploma or equivalent
  • Computer proficiency, including Excel, Word, Publisher, and PowerPoint required
  • COVID Vaccination completed

BENEFITS:

  • Medical, Dental and Vision Insurance begins day 1.
  • Profit sharing and 401(k) benefits
  • Paid company holidays
  • PTO accrual

Job Type: Full-time

Salary: Based on experience, skills and knowledge. Ranges from $13.50 to $17.50

Salary : $14 - $18

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