Pre-Certification Specialist
Company: Orthopedic Associates of Hartford
Location: Hartford
Posted on: August 2, 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.PM22PI187048886
Keywords: Orthopedic Associates of Hartford, Hartford , Pre-Certification Specialist, Other , Hartford, Connecticut
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