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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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