Pre-Certification Specialist
Company: Orthopedic Associates of Hartford
Location: Hartford
Posted on: July 31, 2022
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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
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