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Central Scheduling - PreCert Specialist - 1st Shift - Full Time

Central Scheduling - PreCert Specialist - 1st Shift - Full Time

Wayne Hospital CompanyGreenville, OH, US
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Job Description

Job Description

The Pre-Certification Specialist is responsible for contacting insurance companies for verification of benefits, pre-authorization, and follow up on pre-certification. This position is full time at 8 hours a day, 40 hours a week. The Pre-Certification Specialist reports to the director of Central Scheduling.

Qualifications :

  • High School Diploma or GED Required.
  • Previous work experience in customer service and general clerical / office procedures.
  • At least one-year of experience working in a hospital, medical facility, or insurance company preferred.
  • Medical Terminology certification preferred

Responsibilities / Skills :

  • Verify Insurance coverage for Inpatient, Outpatient (including Observation)
  • Communicate with Case Management whether or not pre-certification is needed.
  • Change patient Stay Types by direction of Case Management.
  • Add / Remove room and Observation charges as needed.
  • Verify prior-authorization obtained by outside sources
  • Follow up with offices if CPT Code does not match CPT authorized.
  • Collects physician orders or verifies that complete and valid orders are on file for each patient.
  • Completes the 5-element check on all Outpatient orders.
  • Arranges or assists with patient transport as necessary
  • May bend, stoop, twist and reach in conjunction with the job requirements.
  • All other duties assigned.
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