Pre-Certification Specialist
Company: Orthopedic Associates of Hartford
Location: Hartford
Posted on: August 4, 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.PM22PI187049172SDL2017
Keywords: Orthopedic Associates of Hartford, Hartford , Pre-Certification Specialist, Other , Hartford, Connecticut
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