Share Email Opening Title Precertification Specialist  Full-Time/Part-Time   Req Number MED-11-00005   Position Precertification Specialist   Full-Time/Part-Time Full-Time   Exempt/Non-Exempt Non-Exempt   Location ELM- Leffingwell Office   Open Date 5/24/2011 4:43:00 PM   Close Date   Description POSITION SUMMARY   With customer service orientation, verifies patient's insurance benefits and eligibility, obtains required authorization, provides procedure codes and fee estimates, and collects prepayment from patients when appropriate.   SUPERVISION: This position does not have supervisory responsibilities.  ESSENTIAL RESPONSIBILITIES   · Monitor scheduled surgeries and maintain organized list with status of pre-certification process. ·Verify insurance eligibility and benefits via phone and/or internet access.  Update insurance policy information in NextGen system as required.  ·  Check insurance payment policy for scheduled procedures and obtain prior authorization when required. · Verify receipt of all necessary pre-authorization documents prior to procedure · Communicate effectively with the facility in which the procedure will be performed as needed. · Assign appropriate ICD9 and CPT codes pre-operatively based on documentation and booking slips. · Notify primary care physician for managed care plans that require PCP authorization. · Supply patients with written or verbal estimates of surgical codes and fees upon request.  · Meet with patients pre-operatively or communicate effectively as necessary with patients so they understand the billing process and their financial expectations pre-operatively. ·Collect pre-payment from the patient when necessary.  · Notify patients with past due accounts of pre-payment policy for elective surgery.  Receive payments from patients.  ·Assist with check-in and check-out when needed.  Serve as a resource on insurance, billing and customer service for reception and cashier. ·Monitor cash box and report balance to supervisor and accounting department monthly. · Perform other duties or functions as assigned.       Position Requirements REQUIRED/DESIRED QUALIFICATIONS   Education, Training and Experience:  Professional coding certification or minimum of two years experience in Orthopaedic surgical coding required.  Employee must have extensive knowledge of anatomy, physiology and medical terminology. Specific skills, knowledge and abilities:  Presents a strong professional appearance Strong verbal communication skills Working knowledge of medical billing and managed care Proven experience handling irate patients/customers and dealing with conflict Familiarity with different insurance types Highly organized and self-motivated Microsoft Office and Windows based computer applications Motor, sensory and physical requirements: Ability to sit for prolonged periods of time. Frequent bending, stooping, lifting and reaching required Employee may be required to lift up to 50 pounds. Manual dexterity required to operate modern office equipment. Employee must have normal or correctible range of hearing and eyesight.     Benefits   EOE Statement We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law.   This position is currently not accepting applications. To search for an open position, please go to http://OAM.appone.com

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