Pre-Certification Specialist

Company: Orthopedic Associates of Hartford
Location: Hartford
Posted on: July 31, 2022

Job Description:

Description:
Established in 1970, Orthopedic Associates of Hartford, P.C., is one of the areas largest orthopedic practices with office locations throughout greater Hartford. Our growing practice is currently seeking a Pre-Certification Specialist. The successful candidate will be a team player who is dependable, organized, enthusiastic, and detail oriented. The Pre-Certification Specialist is accountable for a designated caseload, obtaining and documenting insurance authorizations for surgical procedures completely and in a timely manner. A positive "can-do" attitude is a must.The Pre-Certification Specialist will:Determine if the surgical case requires authorization; obtain prior authorization for surgeries where required.Communicate with insurance companies to provide necessary information to obtain the authorization.Access online insurance portals to enter and obtain authorizations.Communicate with physicians regarding peer-to-peer reviews for insurance companies, and with patients and staff in a prompt, pleasant, and helpful manner.Verify patient demographic and eligibility information and relay changes to appropriate staff.Additional tasks as needed to facilitate authorizations.

Requirements:
High School diploma or GED.Minimum of 2-3 years of related experience in a medical or surgical specialty clinic setting, orthopedic related experience preferred.Must be highly computer literate; experience with Centricity and Allscripts, Microsoft Word, Outlook, and Excel is desirable.Two years of experience related to healthcare insurance verification and/or billing required.Knowledge of clinical terminology.Understanding of patient treatment plans for purposes of obtaining authorizations.Ability to interpret Advanced Practitioner or Physician notes in order to facilitate obtaining authorizations.Ability to evaluate & communicate to medical staff additional requirements or roadblocks.Ability to interpret insurance records and related documentation.Organizational and time management skills, as evidenced by capacity to prioritize multiple tasks and role components.Ability to work independently, multi-task, and exercise sound judgment in interactions with physicians, payors, and patients and their families if required.Strong oral and written communication skills required, with a professional and courteous telephone manner.Highly committed team player; proactive self-starter; reliable and able to be flexible in a changing environment.PM22PI187049259

Keywords: Orthopedic Associates of Hartford, Hartford , Pre-Certification Specialist, Other , Hartford, Connecticut