Pre-Certification Specialist | Savannah
Optim Healthcare is seeking a full time Pre-Certification Specialist for our Savannah location.
- Reviews patients' medical records for appropriate documentation for the scheduled procedure and accurate insurance as appropriate.
- Works with medical and other staff in coordinating medical information and patient charts.
- Responsible for starting and/or completing all pre-certification and benefits for all procedures on the same day the procedure is entered into the pre-certification tool if entered prior to the last hour of the scheduled shift and should follow all ICD-10 requirements by the insurance company.
- Responsible for monthly follows-up with insurance companies ensuring that coverage is in effect until the procedure is performed.
- Ensures that all pre-certifications are completed within the designated insurance company turnaround time parameters as required for review and communicates in a timely manner the outcome of these efforts to all appropriate entities.
- Documents all actions electronically and maintains permanent electronic record in patients' chart and necessary electronic data repositories as required.
- Completes all necessary actions in the pre-cert tool with dates and times as well as maintaining all other computer systems associated with each procedures - i.e. scheduling systems, SRS, APTA, Group Cast, etc.
- Answers patient questions and inquiries regarding the pre-certification status of their procedures.
- Maintains workflow of daily operations with minimal manual paper process to ensure appropriate budgetary guidelines are maintained.
- Researches and assists the revenue cycle with denial research as it pertains to pre-certification or benefit denials.
- Maintains strict confidentiality of sensitive information.
- Performs related work as required.
- Competitive Pay
- Company Benefits
- Vacation, Personal Time Off, and Sick Leave
- Holiday Pay
- 401K Plan
Apply for this position by sending your resume and cover letter to firstname.lastname@example.org