Pre-Certification Specialist - Remote

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    "requisitionDescription": "<div><div><p id=\"isPasted\"><strong>JOB TITLE:</strong>&nbsp; Pre-certification Specialist&nbsp;</p><p><strong>GENERAL SUMMARY OF DUTIES:</strong>&nbsp; Pre-certs all surgeries prior to day of surgery and follows up with insurance companies if diagnosis or procedures changed. &nbsp;Must be familiar with ICD-9 and CPT code books.&nbsp;</p><p><strong>SUPERVISION RECEIVED:</strong>&nbsp; Reports directly to the Surgery Center Supervisor&nbsp;</p><p><strong>SUPERVISION EXERCISED:</strong>&nbsp; None&nbsp;</p><p><strong>TYPICAL PHYSICAL DEMANDS:</strong>&nbsp; Work may require sitting for long periods of time; also stooping, bending and stretching for files and supplies. &nbsp;Occasionally lifting files or paper weighing up to 30 pounds. &nbsp;Requires manual dexterity sufficient to operate a keyboard, type, operate a calculator, telephone, copier and other such office equipment as necessary. &nbsp;Vision must be correctable to 20/20 and hearing must be in the normal range for telephone contacts. &nbsp;It is necessary to view and type on computer screens for long periods and to work in an environment which can be very stressful.&nbsp;</p><p><strong>TYPICAL WORKING CONDITIONS:</strong>&nbsp; Work is performed in an office environment. &nbsp;Involves frequent contact with staff, patients, insurance company representatives and the public. &nbsp;Work may be stressful at times. &nbsp;Contact may involve dealing with angry or upset people.&nbsp;</p><p><strong>DUTIES:</strong>&nbsp; (This list may not include all of the duties assigned).&nbsp;</p><ol start=\"1\" type=\"1\"><li>Reviews patients&rsquo; medical records</li><li>Works with medical and other staff in coordinating medical information and patient charts</li><li>Responsible for pre-certing all surgeries, if required by ICD-9 code with the appropriate insurance company</li><li>Follows-up with insurance companies ensuring that coverage is in effect</li><li>Documents all actions and maintains permanent record in patients&rsquo; chart</li><li>Answers patient questions and inquiries regarding the precert status of their surgeries</li><li>Maintains strict confidentiality of sensitive information</li><li>Performs related work as required&nbsp;</li></ol><p><strong>PERFORMANCE REQUIREMENTS:</strong>&nbsp;</p><p>Knowledge, Skills &amp; Abilities:&nbsp;</p><p>Knowledge of medical terminology. &nbsp;Knowledge of grammar, spelling, and punctuation to type correspondence. &nbsp; Knowledge of insurance industry. &nbsp; Skill in operating a computer and photocopy machine. &nbsp;Ability to read, understand, and follow oral and written instruction. &nbsp;Ability to maintain confidentiality of sensitive information. &nbsp;Ability to sort and file materials correctly by alphabetic or numeric systems. &nbsp; Ability to speak clearly and concisely. &nbsp; Ability to establish and maintain effective working relationships with patients, employees, and the public.&nbsp;</p><p><strong>EDUCATION:</strong>&nbsp; 1. High School Diploma or GED</p><p>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 2. Successful completion of a course in Medical Terminology&nbsp;</p><p><strong>EXPERIENCE:</strong> 1. Minimum of one year experience in a Medical Office</p><p>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 2. Computer Experience&nbsp;</p><p><strong>CERTIFICATE/LICENSE:</strong>&nbsp; None&nbsp;</p><p><strong>ALTERNATIVE TO MINIMUM QUALIFICATIONS:</strong>&nbsp;</p><p>Additional appropriate education may be substituted for experience.</p></div></div>\n",
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